Clinical, radiological and survivorship results after ten years comparing navigated and conventional total knee arthroplasty: a matched-pair analysis

Purpose Our aim was to compare the long-term outcome between navigated and conventional total knee arthroplasty (TKA), which is currently not known. Methods Long-term survivorship, clinical scores and radiographic results of a matched-pair group of 350 patients (350 knees) treated with navigated (n = 157) or conventional (n = 188) TKA for osteoarthritis over a period of 11 years were reviewed retrospectively. Results The mean clinical follow-up was ten years. There were no clinically relevant differences with respect to any clinical outcome, patient satisfaction or pain between the two groups. Coronal leg alignment was closer (1.7-3.1 degrees) to the neutral mechanical axis in the navigated group compared with the conventional group (2.6-4.7 degrees). A total of 12 knees (6.4%) in the conventional group and three (1.9%) in the navigated group underwent revision surgery (p = 0.04), resulting in an absolute risk reduction of 4.5% for revision surgery by using navigation. Using any revision as an end point, the ten-year Kaplan-Meier survivorship was 98.1% in the navigated and 92.5% in the conventional group. Conclusions Navigated TKA improves implant survivorship compared with conventional TKA.