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Knee Navigation Application

Software Guided Knee Surgery

Surgical navigation has been shown to improve alignment¹, reduce revisions² and improve functional outcomes³.

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Software application for guidance during knee surgery
Total Knee Arthroplasty Navigation Software


Today’s active patients demand a natural feeling knee, making precise alignment and individual soft tissue balancing essential in total knee arthroplasty. KNEE3 is a smart, imageless navigation software from Brainlab that visualizes and summarizes the complex interaction between 3D-kinematics, joint stability and implant alignment. KNEE3 is designed to seamlessly fit the surgeon’s technique, quickly assessing cutting block position and simplifying soft tissue management.

  • Visualizes crucial information to analyze and control the prospective clinical outcome prior to any bone resections
  • Automatically follows surgical steps without having to touch the monitor during surgery
  • Flexible features include pinless measured resection to full gap balancing techniques
  • Displays X-Rays and templated plans during navigation
Joint Stability Graph with navigation software

Balance in Motion

The Joint Stability Graph offers a new paradigm to assess joint stability and manage gap balancing in total knee arthroplasty. KNEE3 continuously calculates the resulting joint gaps based on the maximum knee joint mobility and 3D implant geometries. The Joint Stability Graph helps to identify malalignment, instabilities, contractures, and compartment tightness at one glance. While positioning cutting blocks for each respective cut, the surgeon can thereby safely preview the resection’s impact and control the resulting joint stability.

  • Characterizes the knee disease state and predicts the final result
  • Displays gaps through full range of motion based on cutting block position and 3D implant geometries
  • Detects even mid-flexion instabilities
  • Supports decision-making to help ensure the right treatment

KNEE3 Express workflow with Adjustable Cutting Block

Pinless Alignment Verification

KNEE3 provides two options for pinless navigation of knee arthroplasty. The Adjustable Cutting Block from Brainlab allows for live navigation of the distal femoral cut without additional pin placement. The cutting block is placed on the bone with an easy-to-use template and contains adjustment dials to quickly set flexion/extension, varus/valgus, and distal resection while viewing live alignment on the navigation screen. The second option, KNEE3 Express, can be used with conventional instruments and allows for verification of the cutting block position and final cut results without pins. Quick three step registration adds virtually no time to the procedure.

  • Pinless verification of cutting block position and resection outcome
  • Pinless live navigation of femur with Adjustable Cutting Block
  • Compatible with existing conventional instrumentation
  • Minimal impact on surgical procedure and time
  • Allows for software guidance during revision surgeries
ClearLens markers for total knee replacement with navigation

Streamlined Tracking

ClearLens™, the latest passive optical tracking technology from Brainlab, streamlines navigation during software guided surgery. ClearLens is an innovative solution that provides consistent marker visibility, faster setup, and simplified tray management. ClearLens tracking arrays are disposable and packed sterile for easy assembly and clean up.

  • Quick and easy assembly of components
  • Resistant to debris, blood and other liquids
  • Occlusion-tolerant and wipeable
Data Analytics for knee replacement with navigation

Patient Reports and Data Analysis

Navigation systems collect detailed data on knee arthroplasty, including the disease state, cut positions and final corrected outcome. Aggregating and presenting this data can improve communication with patients and enable advanced research. At the end of each procedure, KNEE3 automatically generates patient reports and case data that can be synchronized with Quentry, the secure cloud-based medical image sharing, analytics and collaboration platform from Brainlab.

  • Patient-friendly case reports help educate and engage patients about their software guided surgery
  • KNEE3 automatically generates screenshots and case data that can be easily imported into presentations and spreadsheets
  • Synchronize to Quentry for cloud access to all screenshots and metadata from navigated cases




Mason JB, Fehring TK, Estok R, et al. Meta-Analysis of alignment Outcomes in Computer-Assisted Total Knee Arthroplasty Surgery. J Arthorplasty 2007; 22(8): 1097-1106.


De Steiger R, Liu Y-L, Grave SE. Computer navigation for total knee arthroplasty reduces revision rate for patients less than sixty-five years of age. J Bone Joint Surg Am 2015; 8: 635-642.


Lehnen K, Giesinger K, Warschkow R, et al. Clinical outcome using a ligament referencing technique in CAS versus conventional technique. Knee Surg Sports Traumatol Arthrosc 2011; 18(19): 887-892.