Total knee arthroplasty is a well established treatment modality for knee osteoarthritis with an 82% satisfactory outcome as reported by the Swedish Knee Arthroplasty Register. Overall revision rate is 15% at 10 years with aseptic loosening and instability being the most common indication for revision. Axial alignment of limb with restoration of mechanical axis within a range of +/− 3° varus/valgus is thought to be associated with a better outcome. Although short term outcome results show no significant differences in CAS TKR versus traditional TKR, we expect long term clinical outcome to be better.

The primary aim is to investigate the benefits and pitfalls of using CAS TKR such as improved component alignment and restoration of mechanical axis. In addition, we also share our experience of the current PiGalileo™ Computer Navigated System (ENDOPLUS®).

Since October 2002 we have performed over 80 CAS TKR. We have prospectively collected pre and post operative data of patients undergoing CAS TKR and analysed the operative details, as well as evaluated their WOMAC and Knee Society Scores. We looked in particular at the performance of PiGalileo™ Computer Navigated System (ENDOPLUS®).

We have positive experience with PiGalileo™ Navigation System. We have had no computer related complications. We recognize although the system is user friendly, it naturally involves a learning curve. Surgeries done with PiGalileo™ are still performed by a surgeon, with navigation and mechanized technologies aiding the surgeon in instrument positioning. Surgeons are provided with critical real-time intra-operative feedback to help improve precision, leading to better implant alignment and positioning of the implants to a degree of accuracy not possible with the naked eye. The achievable accuracy of implant positioning is less than 1 mm, and less than 1°. Data is currently being collected to prove the superior long term clinical outcome of such accuracy.