Computer-assisted surgery for total knee arthroplasty can be performed with use of computer-assisted navigation, handheld navigation, partially or fully robot-assisted technology, and patient-specific instrumentation.

Computer-assisted navigation leads to improved component alignment and a reduction in the likelihood of mechanical axis outliers after total knee arthroplasty, but it is not known whether these differences have any long-term benefit on clinical or functional outcomes.

Handheld navigation is a form of computer-assisted navigation that includes accelerometer and sensor-based technology. While largely unproven in the clinical literature, it offers many potential advantages over traditional navigation.

Robot-assisted surgery has not been extensively studied in the context of unicompartmental and total knee arthroplasty, and, although initial reports have been promising in terms of accuracy and precision, this method is associated with substantial cost and a steep learning curve.

Patient-specific instrumentation was designed to overcome many of the intraoperative challenges associated with navigation or robotic surgery, but early reports have demonstrated only minor improvements in surgical accuracy, and no change in outcomes, compared with conventional total knee arthroplasty.