Custom-Made Devices Represent a Promising Tool to Increase Correction Accuracy of High Tibial Osteotomy: A Systematic Review of the Literature and Presentation of Pilot Cases with a New 3D-Printed System

Zaffagnini, Stefano; Fabbro, Giacomo Dal; Belvedere, Claudio; Leardini, Alberto; Caravelli, Silvio; Lucidi, Gian Andrea; Agostinone, Piero; Mosca, Massimiliano; Neri, Maria Pia; Grassi, Alberto

doi:10.3390/jcm11195717

Cited by 7 publications

(10 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These improvements include intraoperative navigation, 3-D printing for surgical assistance, and other technologies. [36][37][38] Intraoperative aids help precisely position the osteotomy site, such as the bone surface around the osteotomy line and proximal tibial "H" point. [39] They also confirm the correction angle, reducing operation time and minimizing the need for multiple fluoroscopic confirmations, thus streamlining the surgical procedure.…”

Section: Discussionmentioning

confidence: 99%

Osteotomy for treating knee osteoarthritis from 2012 to 2023: Bibliometric analysis and global trends

Hou,

Xiao,

Peng

et al. 2024

Medicine

View full text Add to dashboard Cite

Background: Numerous surgical interventions are available for the treatment of knee osteoarthritis (KOA). In recent years, knee-preserving surgery, specifically osteotomy, has gained significant attention from patients, particularly those who are young and physically active, as it not only effectively alleviates pain but also preserves bone integrity, thereby allowing for potential future joint replacement. This study aims to comprehensively analyze the global application trends of osteotomy for KOA and identify the current research hotspots. Methods: We conducted a literature search encompassing English-language studies on osteotomy for KOA published from 2012 to 2023 in the Web of Science Core Collection (WoSCC) database. Bibliometric analysis tools, including VOSviewer, CiteSpace, and R Studio, were employed to analyze global trends and research hotspots. Results: We analyzed 1520 eligible publications, comprising 1350 articles and 170 reviews. The number of articles on osteotomy for KOA has exhibited a consistent upward trend over the past decade. The top 3 contributing countries (South Korea, United States, and China) accounted for 45.98% of all published articles. U.S. scholars exhibited high productivity, prominence, and academic impact in this field. Seoul National University published the most papers on the relationship between osteotomy and KOA, while Sungkyunkwan University had the highest average citation rate. Among authors, Yong Seuk Lee from Korea and Steffen Schroeter from Germany had the highest number of publications and average citation values, respectively. Research interests were clustered into 5 categories: “High tibial osteotomy,” “Biomechanics of osteotomy,” “Osteotomy combined with cartilage repair techniques,” “Postoperative prognosis and outcomes,” and “Improvement of surgical techniques.” Conclusion: Recent years have witnessed notable rapid progress in the research on osteotomy for KOA. The field is poised for continued growth in terms of academic literature. The United States has emerged as a global leader in knee osteotomy research, while Korea demonstrates considerable potential in this domain. Future research hotspots may encompass high tibial osteotomies, osteotomies combined with cartilage repair techniques, and advancements in surgical techniques for KOA.

show abstract

Section: Discussionmentioning

confidence: 99%

Osteotomy for treating knee osteoarthritis from 2012 to 2023: Bibliometric analysis and global trends

Hou,

Xiao,

Peng

et al. 2024

Medicine

View full text Add to dashboard Cite

show abstract

“…Still, the results of knee osteotomies are often suboptimal, despite some recent advancements like new planning software, pre‐shaped cutting blocks, computer‐assisted navigation, customized corrections, etc. [14, 21, 45, 74]. This fostered research efforts to further improve the clinical outcome.…”

Section: Introductionmentioning

confidence: 99%

Biological intra‐articular augmentation for osteotomy in knee osteoarthritis: strategies and results

Reale

Feltri²,

Franceschini

et al. 2023

Knee surg. sports traumatol. arthrosc.

View full text Add to dashboard Cite

Purpose To assess whether there is evidence supporting the use of augmentation strategies, either cartilage surgical procedures or injective orthobiologic options, to improve the results of osteotomies in knees with osteoarthritis (OA). Methods A systematic review of the literature was performed on the PubMed, Web of Science and the Cochrane databases in January 2023 on osteotomies around the knee associated with augmentation strategies (either cartilage surgical procedures or injective orthobiologic options), reporting clinical, radiological, or second‐look/histological outcomes at any follow‐up. The methodological quality of the included studies was assessed with the Coleman Methodology Score (CMS). Results Out of the 7650 records identified from the databases, 42 articles were included for a total of 3580 patients and 3609 knees treated; 33 articles focused on surgical treatments and 9 on injective treatments performed in association with knee osteotomy. Out of the 17 comparative studies with surgical augmentation, only 1 showed a significant clinical benefit of an augmentation procedure with a regenerative approach. Overall, other studies showed no differences with reparative techniques and even detrimental outcomes with microfractures. Regarding injective procedures, viscosupplementation showed no improvement, while the use of platelet‐rich plasma or cell‐based products derived from both bone marrow and adipose tissue showed overall positive tissue changes which translated into a clinical benefit. The mean modified CMS score was 60.0 ± 12.1. Conclusion There is no evidence to support the effectiveness of cartilage surgical treatments combined with osteotomies in terms of pain relief and functional recovery of patients affected by OA in misaligned joints. Orthobiologic injective treatments targeting the whole joint environment showed promising findings. However, overall the available literature presents a limited quality with only few heterogeneous studies investigating each treatment option. This ORBIT systematic analysis will help surgeons to choose their therapeutic strategy according to the available evidence, and to plan further and better studies to optimize biologic intra‐articular osteotomy augmentation. Level of evidence Level IV.

show abstract

“…With the aim of improving biomechanical and clinical results, a personalized system was developed recently [12,[23][24][25]. An accurate 3D planning procedure based on medical imaging of the patient, including computed tomography (CT) of the knee in addition to standard weight-bearing long-leg radiographs, is performed before HTO.…”

Section: Introductionmentioning

confidence: 99%

Instrumental Gait Analysis and Tibial Plateau Modelling to Support Pre- and Post-Operative Evaluations in Personalized High Tibial Osteotomy

Belvedere,

Gill,

Ortolani

et al. 2023

Applied Sciences

Self Cite

View full text Add to dashboard Cite

High tibial osteotomy (HTO) is intended to treat medial knee osteoarthritis by realigning the joint such that the loading in the knee during functional activity shifts laterally. The aim of this study was to use a novel methodology combining motion analysis and 3D modelling to assess the efficacy of this surgery in changing the loading location in the knee in a cohort of 25 patients treated with personalized HTO. Pre-operatively and at 6 months post-surgery, weight-bearing CT and gait analysis during level walking were performed on all patients, as well as clinical evaluations using KOOS and VAS scores. CT scans were used to generate a knee bone model and a virtual tibial plateau plane; the intersection pattern between this plane and the ground reaction force (GRF) vector was calculated in the pre- and post-operative gait analyses. Clinical scores improved significantly (p < 0.001) after surgery (pre-/post-operative KOOS and VAS: 56.2 ± 14.0/82.0 ± 8.3 and 6.3 ± 1.7/1.5 ± 1.7). Post-operative GRF-to-tibial plateau intersection patterns were significantly (p < 0.001) more lateral (31.9 ± 19.8% of tibial plateau width) than the pre-operative patterns. Personalized HTO successfully and consistently lateralizes the GRF at the knee, in association with significant improvements in function and pain. The novel combination of 3D bone modelling and motion analysis also has the potential to further aid HTO surgical planning.

show abstract

Custom-Made Devices Represent a Promising Tool to Increase Correction Accuracy of High Tibial Osteotomy: A Systematic Review of the Literature and Presentation of Pilot Cases with a New 3D-Printed System

Cited by 7 publications

References 39 publications

Osteotomy for treating knee osteoarthritis from 2012 to 2023: Bibliometric analysis and global trends

Osteotomy for treating knee osteoarthritis from 2012 to 2023: Bibliometric analysis and global trends

Biological intra‐articular augmentation for osteotomy in knee osteoarthritis: strategies and results

Instrumental Gait Analysis and Tibial Plateau Modelling to Support Pre- and Post-Operative Evaluations in Personalized High Tibial Osteotomy

Contact Info

Product

Resources

About