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

Na, Young Gon; Eom, Sang Hwa; Kim, Seok Jin; Chang, Moon Jong; Kim, Tae Kyun

doi:10.1007/s00264-015-2880-x

Cited by 26 publications

(16 citation statements)

References 26 publications

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“…The target correction angle in coronal alignment was presented with different radiographic parameters in each study: hip–knee–ankle angle (HKA) in seven studies 14 , 15 , 17 , 18 , 20 , 24 , 31) , femorotibial angle (FTA) in two studies, which were reports of the same authors 12 , 13) , and weight bearing line coordinate (WBL) in seven studies ( Table 2 ) 11 , 13 , 14 , 16 , 18 , 19 , 31) . The target was similar but not perfectly identical across the studies.…”

Section: Resultsmentioning

confidence: 99%

Navigated versus Conventional Technique in High Tibial Osteotomy: A Meta-Analysis Focusing on Weight Bearing Effect

Nha

Shin

Kwon

et al. 2019

Knee Surg Relat Res

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Section: Resultsmentioning

confidence: 99%

Navigated versus Conventional Technique in High Tibial Osteotomy: A Meta-Analysis Focusing on Weight Bearing Effect

Nha

Shin

Kwon

et al. 2019

Knee Surg Relat Res

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“…Previous studies showed that postoperative PTS increases in patients who underwent OWHTO with navigation is significantly lower than that in the conventional group, but postoperative coronal alignment in both groups were almost identical. [23][24][25][26] Increased PTS in knees with intact anterior cruciate ligaments might cause more anterior cruciate ligament tension because increased PTS in knees with deficient anterior cruciate ligaments after OWHTO redistribute tibiofemoral contact pressures posteriorly. 12 Maintaining original PTS is crucial, but very few surgeons use a computer navigation system during OWHTO.…”

Section: Discussionmentioning

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 …”

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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.…”

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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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“…Computer-assisted HTO can also provide real-time intraoperative information concerning coronal, sagittal and transverse axes, which can compensate for the shortcomings of preoperative radiographic planning. It can improve postoperative results with decreased radiation exposure 731)…”

Section: Advantages and Literature Reviewmentioning

confidence: 99%

Computer-Assisted Navigation in High Tibial Osteotomy

Song

Bae

2016

Clin Orthop Surg

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Computer-assisted navigation is used to improve the accuracy and precision of correction angles during high tibial osteotomy. Most studies have reported that this technique reduces the outliers of coronal alignment and unintended changes in the tibial posterior slope angle. However, more sophisticated studies are necessary to determine whether the technique will improve the clinical results and long-term survival rates. Knowledge of the navigation technology, surgical techniques and potential pitfalls, the clinical results of previous studies, and understanding of the advantages and limitations of the computer-assisted navigation are crucial to successful application of this new technique in high tibial osteotomy. Herein, we review the evidence concerning this technique from previous studies.

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

Abstract: Level III, retrospective comparative study.

Cited by 26 publications

References 26 publications

Navigated versus Conventional Technique in High Tibial Osteotomy: A Meta-Analysis Focusing on Weight Bearing Effect

Navigated versus Conventional Technique in High Tibial Osteotomy: A Meta-Analysis Focusing on Weight Bearing Effect

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

Computer-Assisted Navigation in High Tibial Osteotomy

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