113 elderly Asian patients with bilateral knee osteoarthritis (OA) and genu varus deformity were randomized to receive either computer-assisted total knee arthroplasty or conventional total knee arthroplasty. Each patient received treatment on both knees with each intervention being performed on separate knees. Randomization occurred on the basis of operative technique and which treatment was preformed first. Post-surgery radiographic analysis revealed that patients with preoperative mechanical axis deviations of greater than 20 degrees were significantly closer to normal axes after computer-assisted surgery in comparison to the conventional approach. Additionally, knees from the computer-assisted group had restoration of the mechanical axis within 3 degrees.