In an effort to improve the results of Knee and Hip replacement computer navigation is beginning to be used.

The proposed advantages of computer navigation are better placement of implants. This will hopefully translate into longer survivorship of the implants. There are some patients in whom, due to previous surgery or injury, traditional methods of navigation are difficult or impossible. In these cases computer navigation can enable surgery.

Initially studies have not shown an increase in survivorship for knee implants using computer navigation. These are relatively early studies.

There are some potential downsides to computer navigation. The surgery takes more time with computer navigation, potentially increasing the rate of infection. Metal pins are inserted into the bones at the time of surgery and these can on occasion cause fractures. Computer navigation currently does not provide assistance with all of the steps of knee replacement, several important steps (particularly regarding rotation and patellofemoral alignment) must be done freehand.

I do not use computer navigation as a routine. I do think it has a place, particularly, where previous surgery or injury, make the proposed surgery difficult.

Other surgeons would have different views on this.