200 patients scheduled to total knee arthroplasty were randomized to either receive a component implantation using computer assistance or through the conventional technique. The purpose was to determine if groups differed in component survival, radiological, clinical evaluation or clinical scoring at a minimum of 5 years follow-up. Overall, no significant difference in component survival was observed between groups. The computer assisted TKA group was observed to have some benefit in radiographic coronal alignment; however this did not improve component survival at 5 year follow-up.