Preoperative surgical planning versus navigation system in valgus tibial osteotomy: a cross-sectional study

Ribeiro, Cristiano Hossri; Severino, Nilson Roberto; Fucs, Patrícia Maria de Moraes Barros

doi:10.1007/s00264-013-1960-z

Cited by 30 publications

(25 citation statements)

References 23 publications

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“…Although this considerable frequency of outliers may reflect the relatively narrow target range, the inherent limitation of the navigation system appears to be the major cause of outliers. Navigated surgery, which is performed with the patient supine, cannot fully reflect the standing position with full weight bearing status [27]. In addition, correction of the coronal alignment may alter the knee adduction moment, which can cause the alignment to deviate from the pre-operatively estimated result.…”

Section: Discussionmentioning

confidence: 99%

The use of navigation in medial opening wedge high tibial osteotomy can improve tibial slope maintenance and reduce radiation exposure

Eom

Kim

et al. 2015

International Orthopaedics (SICOT)

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Section: Discussionmentioning

confidence: 99%

The use of navigation in medial opening wedge high tibial osteotomy can improve tibial slope maintenance and reduce radiation exposure

Eom

Kim

et al. 2015

International Orthopaedics (SICOT)

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“…Moreover, several authors have described superior intraoperative accuracy using navigation systems for HTO. 15,16 In this feasibility study, we describe a new intraoperative three-dimensional (3D) positioning technique for calculating the location and dimensions of an opening wedge HTO and for surgically reproducing the planned osteotomy with safety and efficacy in a reduced surgical time.…”

Section: Introductionmentioning

confidence: 99%

3D Surgical Printing Cutting Guides for Open-Wedge High Tibial Osteotomy: Do It Yourself

et al. 2016

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Opening wedge osteotomy has recently gained popularity, thanks to the recent implementation of locking plates, which have shown equivalent stability with greater reproducibility, accuracy, and longevity than the closing wedge techniques and a lower prosthetic conversion rate. We present a new "do-it-yourself" cutting guides system for tibial opening osteotomy. Using a conventional computed tomography digital image, a positioning guide and wedge spacers were printed in three dimensions (3D) for implementing the osteotomy and obtaining the planned correction. The surgeon makes the whole process in a do-it-yourself style. This new technique was used in eight cases. Previous opening osteotomies with the standard technique were used as control (20 cases). Surgical time, fluoroscopic time, and accuracy of the axial correction were measured. The use of a custom positioning guide reduced the surgical (31 minutes less) and fluoroscopic times (6.9 times less) while achieving a high-axis correction accuracy compared with the standard technique. Digitally planned and executed osteotomies under 3D printed osteotomy positioning guides help the surgeon to minimize human error while reducing surgical time. The reproducibility of this technique is very robust, allowing a transfer of the steps planned in a virtual environment to the operating table.

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“…Other reasons for failure include inaccurate correction during surgery. Furthermore, undercorrection [8] leads to progression of medial joint arthritis [9] and patient dissatisfaction [10]. On the other side, overcorrection leads to patellar subluxation, patella baja [9], medial joint opening [7] and rapid degeneration of the lateral cartilage [11].…”

Section: Introductionmentioning

confidence: 99%

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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Preoperative surgical planning versus navigation system in valgus tibial osteotomy: a cross-sectional study

Abstract: There was a significant difference in the calculation of the wedge opening between the DM and NS. HTO without the aid of the NS could theoretically lead to undercorrection of the deformity.

Cited by 30 publications

References 23 publications

The use of navigation in medial opening wedge high tibial osteotomy can improve tibial slope maintenance and reduce radiation exposure

The use of navigation in medial opening wedge high tibial osteotomy can improve tibial slope maintenance and reduce radiation exposure

3D Surgical Printing Cutting Guides for Open-Wedge High Tibial Osteotomy: Do It Yourself

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

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