Comparative Study of Opening-Wedge High Tibial Osteotomy With and Without a Combined Computed Tomography–Based and Image-Free Navigation System

Akamatsu, Yasushi; Kobayashi, Hideo; Kusayama, Yoshihiro; Kumagai, Ken; Saito, T.

doi:10.1016/j.arthro.2016.02.018

Cited by 29 publications

(27 citation statements)

References 48 publications

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“…The level of osteotomy in the proximal medial cortex of the tibia was set at 35 mm from the medial tibial plateau because the position of the locking plates for OWHTO was chosen based on previous studies (Fig. Aa) . The correction angle for each case in which 3D planning was used was measured with methods similar to the 2D planning protocol (Fig.…”

Section: Methodsmentioning

confidence: 99%

“…2Aa). 23,24 The correction angle for each case in which 3D planning was used was measured with methods similar to the 2D planning protocol (Fig. 1A).…”

Section: D Planning Studymentioning

confidence: 99%

“…In addition, it is unclear whether preoperative 3D planning contributes to more precise postoperative realignment in the clinical setting. We hypothesize that clarifying both issues in OWHTO will provide clinically relevant information for intraoperative decision‐making in the absence of a computer‐assisted navigation system that surgeons have used to control PTS …”

mentioning

confidence: 99%

“…We hypothesize that clarifying both issues in OWHTO will provide clinically relevant information for intraoperative decision-making in the absence of a computer-assisted navigation system that surgeons have used to control PTS. [23][24][25][26][27] The objective of this study was to define the correlation between the anterior and posterior widths of the medial opening gap for maintaining preoperative PTS and to assess the degree of coronal and sagittal correction error when the osteotomy surface is opened from the anteromedial direction using a preoperative planning software program. In addition, we evaluated differences in preoperative 2D and 3D plans and postoperative correction accuracy using 3D planning in the clinical setting.…”

mentioning

confidence: 99%

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Clinical efficacy of preoperative 3D planning for reducing surgical errors during open‐wedge high tibial osteotomy

Kuriyama

Morimoto²,

Shimoto

et al. 2019

Journal Orthopaedic Research

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Increases in posterior tibial slope (PTS) with open‐wedge high tibial osteotomy (OWHTO) are often related to two surgical errors: Symmetric opening of the osteotomy gap and a tendency to open the gap from the anteromedial direction. The study objective was to define trends in these two errors using computer simulation and clinical effects of their countermeasures. First, 60 knees with varus deformity were assessed with three‐dimensional (3D) planning using computed tomography to allow for the mechanical axis to pass through a point at 62.5% of the width of the tibial plateau, defined as the weight‐bearing line percentage (WBL%). Anterior and posterior widths of the opening gap to maintain PTS were measured. The effect on PTS when osteotomy gaps were opened from the anteromedial direction up to 30° was evaluated. Mean anterior width (y) was 6.6 mm (range, 2.2–10.9) and mean posterior width (x) was 9.1 mm (range, 3.9–15.7), which can be expressed as y = 0.75x − 0.24. Opening gaps from the anteromedial direction at 10°, 20°, and 30° led to a mean PTS increase of 1.9°, 3.9°, and 5.6°, respectively. In most cases, WBL% with anteromedial opening at 30° passed through a point at less than 60%. In 47 knees that underwent OWHTO using 3D planning, postoperative coronal and sagittal bone corrections were mostly accurate. However, postoperative WBL% was negatively correlated with correction angle because of difficulties in predicting medial joint tightness. Preoperative 3D planning for OWHTO can reduce surgical errors, but postoperative WBL% remains variable. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res

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Section: Methodsmentioning

confidence: 99%

“…2Aa). 23,24 The correction angle for each case in which 3D planning was used was measured with methods similar to the 2D planning protocol (Fig. 1A).…”

Section: D Planning Studymentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Clinical efficacy of preoperative 3D planning for reducing surgical errors during open‐wedge high tibial osteotomy

Kuriyama

Morimoto²,

Shimoto

et al. 2019

Journal Orthopaedic Research

View full text Add to dashboard Cite

show abstract

“…In this issue, we present a report comparing the two methods; the report showed that the PACS method yielded more accurate results with less radiation exposure. Some surgeons have suggested that HTO using a navigation system results in an accurate correction angle7,8). However, navigation-assisted HTO is performed in the non-weight bearing status, and thus the correction angle will change postoperatively in weight bearing status.…”

mentioning

confidence: 99%