The aim of the study was to assess the consistency of the non-image-based navigation system OrthoPilot, Aesculap, Tuttlingen, Germany, in total knee arthroplasty (TKA) implantation in 5 European centers. Two hundred thirty-five TKAs implanted with this navigation system were matched (according to severity of the preoperative coronal deformation and body mass index) to a historical control group of 235 TKAs implanted with a conventional technique. Consistency of implantation was studied on a 3-month postoperative radiological control with coronal long-leg and sagittal standard x-rays. The use of the OrthoPilot navigation system allowed a statistically significant improvement in the consistent placement of both tibial and femoral components. In accordance with current literature, survival of the navigated implanted prostheses is expected to be longer.