Computer assistance in total knee replacement - a critical assessment of current health care technology.

The last five years have seen the rapid development of computer assisted surgery (CAS) in total knee replacement (TKR). Many surgeons perform TKR using navigation systems, which offer user-friendly workflows and reproducible results. A number of level 1 and 2 studies, according to evidence-based medicine criteria, have demonstrated that navigation in TKR allows a more precise implantation of the prosthesis, though CAS still requires an experienced surgeon and is time consuming. Nevertheless, 30% of surgeons in Germany who perform TKR have used navigation. It is still not known whether this new technique improves the longevity of TKR, however, and we therefore performed a meta-analysis to assess the results of this new health care technology.