Navigated opening wedge high tibial osteotomy improves intraoperative correction angle compared with conventional method

Akamatsu, Yasushi; Mitsugi, Naoto; Mochida, Yuichi; Taki, Naoya; Kobayashi, Hideo; Takeuchi, Ryohei; Saito, T.

doi:10.1007/s00167-011-1616-8

Cited by 91 publications

(113 citation statements)

References 34 publications

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“…In our study, the navigation system did not improve the precision in the correction of the mechanical axis (p=0.733), as previously shown in the literature; Lützner et al [15], in their experiment with 19 cadavers, obtained better correction of the line of load with navigation, and Akamatsu et al [21] also concluded that navigation can reduce the risk of hypocorrection, allowing better intra-operative control of the mechanical axis and tibial slope as compared with the traditional technique. In our clinical study, despite the lack of significant differences between groups regarding the mean mechanical axis, we did observe that the dispersion was higher in the control group; the coefficient of variation of the mechanical axis was 58 % around the mean for the navigation system and 97 % around the mean for the control group, operated with the traditional open wedge HTO.…”

Section: Discussionsupporting

confidence: 87%

“…The mechanical axis was better controlled, but the tibial slope and the clinical evaluation were different. In the study by the Kim group [16], the clinical outcome was better with the navigation system, but not the control of the tibial slope; on the other hand, Akamatsu et al [21] obtained better slope control but this was not reflected in improvement of the clinical aspects. In both studies the mean follow-up time was 12 months, like in ours, and follow-up is indeed one of the limitations of our study.…”

Section: Discussionmentioning

confidence: 93%

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Opening wedge high tibial osteotomy: navigation system compared to the conventional technique in a controlled clinical study

Ribeiro

Severino

Fucs

2014

International Orthopaedics (SICOT)

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Purpose This study aimed to verify if the navigation system used in high tibial osteotomy (HTO) adds precision to the procedure regarding mechanical axis correction and prevention of tibial slope increases. Methods In this historically controlled study, patients with medial osteoarthrosis and genuvarum underwent HTO between 2004 and 2012; the first 20 were operated with the conventional technique, using pre-planning correction by the Dugdale method and 18 further patients were operated with the navigation system introduced in our hospital. Results The two groups were similar for pre-operative mechanical axis (mean 8.10±3.14 for the control and 6.60± 2.50 for the navigated group), pre-operative tibial slope (mean 8.95±3.47 versus 8.17±3.11, respectively) and Lyshom score (40.85±15.46 and 44.83±16.86). After surgery, the control group presented mean mechanical axis of 3.35±3.27, tibial slope of 13.75±3.75 and Lyshom score of 87.60±11.12. The navigated group showed a postoperative mechanical axis mean of 3.06±1.70, tibial slope of 10.11±0.18 and Lyshom score of 91.94±11.61. Conclusions The navigation system allowed a significantly better control of tibial slope. Patients operated with the navigation system had significantly better Lysholm scores.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 93%

Opening wedge high tibial osteotomy: navigation system compared to the conventional technique in a controlled clinical study

Ribeiro

Severino

Fucs

2014

International Orthopaedics (SICOT)

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“…5,16) Our hypothesis was that the amount of SPA performed by elderly patients might improve after OWHTO. However, the improvement ratio of SPA was 19.6% (<20%).…”

Section: Discussionmentioning

confidence: 99%

“…1,2) By changing the axis of the lower limb using an extra-articular approach, OWHTO preserves the native articular surface and decreases the excess stress in the medial compartment of the knee. [3][4][5] After OWHTO, patients generally have no limits on their activities of daily living. Excellent clinical results of OWHTO have been reported.…”

Section: Introductionmentioning

confidence: 99%

“…Excellent clinical results of OWHTO have been reported. [1][2][3][4][5] However, the activities performed by patients with knee OA before and after osteotomy have rarely been described. The sports and physical activities (SPA) performed by patients with knee OA before and after valgus knee osteotomy have been investigated and several reports have been published.…”

Section: Introductionmentioning

confidence: 99%

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Sports and Physical Activities of Elderly Patients with Medial Compartment Knee Osteoarthritis after High Tibial Osteotomy

Kamada

Shiota

Sakamoto

et al. 2017

PRM

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The relationship between the posterior tibial slope and the sagittal femoral condylar shape: Two circles and ellipses

Zhang

Wen

et al. 2020

Clinical Anatomy

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Background Whether the posterior tibial slope (PTS) is associated with the femoral condylar shape has remained unclear. Classical anatomical studies considered the sagittal profiles of femoral condyles to consist of two circles. Recently, an elliptical method was described to simplify the “two circles” model. Our purpose was to analyze the relationship between the PTS and the shape of the sagittal femoral condyle, that is, two circles and two ellipses, using magnetic resonance imaging (MRI) scans. Methods Eighty right knees of healthy subjects were scanned by MRI at full extension. The medial and lateral PTS were measured (mPTS and lPTS). On the distal‐most medial and lateral slices, the femoral condylar articular surfaces were best fitted by circles or ellipses, respectively. The radii of the medial and lateral posterior circles and inferior circles (rm and rl, Rm and Rl, respectively), the semi‐major axes and the semi‐minor axes of the medial and lateral ellipses (am and al, bm and bl, respectively), and the rm/Rm, bm/am, rl/Rl, bl/al ratios were measured and calculated. Results mPTS correlated significantly with the parameters of the medial condyle (all p < .05) and the ratios bm/am and rm/Rm (p = .017 and p = .027, respectively). However, the lPTS did not correlate with the parameters of the lateral condyle (all p > .05) or the ratios bl/al and rl/Rl (p = .461 and p = .241, respectively). Conclusion The mPTS is associated with the sagittal shape of the medial femoral condyle but the lPTS is not. Both two circles and two ellipses are feasible ways to represent the sagittal femoral condylar shape.

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Navigated opening wedge high tibial osteotomy improves intraoperative correction angle compared with conventional method

Abstract: III.

Cited by 91 publications

References 34 publications

Opening wedge high tibial osteotomy: navigation system compared to the conventional technique in a controlled clinical study

Opening wedge high tibial osteotomy: navigation system compared to the conventional technique in a controlled clinical study

Sports and Physical Activities of Elderly Patients with Medial Compartment Knee Osteoarthritis after High Tibial Osteotomy

The relationship between the posterior tibial slope and the sagittal femoral condylar shape: Two circles and ellipses

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