Do you think it's safe to have a knee replacement using a computer? What if there's an error in the program? Will I end up with a bum knee?

Many changes have been made in the way total knee replacements (TKRs) can be done surgically. The standard, open incision is still the most common approach.

But new and improved surgical tools and computer equipment have opened up many more possibilities. The minimally invasive (MI) approach uses a much smaller incision than the standard surgery. The surgeon uses a special tool with a tiny TV camera on the end. The camera allows the surgeon to see inside the joint.

MI surgery is not perfected yet. The surgeon does have a view but it is limited. With experience, the surgeon is able to complete the replacement with less blood loss. The patient often has a faster recovery since less soft tissue is cut in the process.

Computer-assisted navigation adds yet another benefit. This program makes it possible to obtain a neutral alignment of the implant. Poor alignment is what often leads to joint pain, loss of function, and even implant failure.

Efforts are being made now to combine computer-assisted navigation with the MI approach. Using both together, studies show it is possible to get within three degrees of normal or neutral alignment. Patients regain function faster and leave the hospital sooner.

In time, these more advanced types of surgery may be able to save on the cost of a TKR. Total rehab costs may also be decreased if the patient is able to go home sooner. More study is needed to make sure patients aren't losing function or trading some benefit from the standard approach by having these more advanced methods.

There’s no real concern about the program being in error or failing. These kinds of programs are tested and retested over an over before ever being used on a human. The surgeon’s skill is still what you count on for a good result.