The weight-bearing scanogram technique provides better coronal limb alignment than the navigation technique in open high tibial osteotomy

Lee, Dae-Hee; Han, Seoung-Bum; Oh, Kwang-Jun; Lee, Jun Seop; Kwon, Jae Ho; Kim, Jong-In; Patnaik, Smarajit; Shetty, Gautam M.; Nha, Kyung-Wook

doi:10.1016/j.knee.2012.09.003

Cited by 67 publications

(51 citation statements)

References 21 publications

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“…Postoperative coronal and sagittal bone corrections based on 3D planning were mostly accurate, but postoperative WBL% was variable in this clinical study. Several studies have shown a discrepancy between plans based on AP full‐leg‐length radiographs in the standing and supine positions . In contrast, another study showed no difference between plans .…”

Section: Discussionmentioning

confidence: 97%

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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: Discussionmentioning

confidence: 97%

“…Several studies have shown a discrepancy between plans based on AP full-leg-length radiographs in the standing and supine positions. [35][36][37] In . Schema showing the proximal and distal osteotomy planes opened from the anteromedial direction.…”

Section: Discussionmentioning

confidence: 99%

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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“…[8] Ortoröntgenogramların, deformite miktarını tespit etmede çok başarılı bir yöntem olduğunu belirten pek çok çalışma vardır. [1,2,[9][10][11] Buna karşın bazı çalışmalarda da özellikle bacağın rotasyonuna bağlı olarak, çekilen grafilerin hatalı sonuçlar verebileceği belirtilmektedir. Hunt ve ark.nın [3] çalışmasında, bacaktaki rotasyonun mevcut deformite derecesi üzerine oldukça etkili olduğu gösterilmiştir.…”

Section: Discussionunclassified

“…[1,2] Ortoröntgenogramların, hasta ayakta iken ve diz kapakları tam olarak öne bakacak şekilde çekilmesi hemen hemen evrensel olarak kabul görmekle beraber, bacakların çekim esnasında tam olarak hangi pozisyonda durması gerektiği konusunda bir fikir birliği bulunmamaktadır. Bu konuda yapılan bazı çalışmalarda bacaktaki rotasyonun, ekstremite dizilimi ile ilgili olarak yapılan ölçümleri nasıl değiştirdi-ğine dair bazı veriler ortaya konmuşsa da bacakların orta hatta olan uzaklığının bu değerleri nasıl etkilediği tam olarak bilinmemektedir.…”

Section: Objectivesunclassified

How safe are orthoroentgenograms in determining the amount of correction for varus deformities?

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et al. 2014

Eklem Hastalik Cerrahisi

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“…Preoperatively, all patients underwent a full-length hip-toankle standing scanogram. 13 A full-size (100%) image of the radiograph was then printed on paper. Using this full-size paper printout, the mechanical axis of the lower limb (center of the hip to the center of the ankle) was plotted and the percentage of the weight-bearing line (WBL) at the tibia was calculated.…”

Section: Surgical Technique Preoperative Planningmentioning

confidence: 99%

Correlations between Navigation and Radiographic Measures of Alignment

Han

Lee

2016

J Knee Surg

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This study was designed to compare the correlations between intraoperative navigation and radiographic alignment in patients who underwent total knee arthroplasty (TKA) and open wedge high tibial osteotomy (HTO). The reliability of navigation and radiographic alignment before and after surgery was compared in 82 prospectively enrolled patients who underwent open wedge HTO and 91 knees that underwent TKA. The absolute difference in preoperative mechanical axis (MA) between navigation and radiography was 1.1 degrees greater in the TKA than in the HTO group (2.6 vs. 1.5 degrees, < 0.001). Postoperatively, however, the absolute difference between navigation and radiographic measurements of MA was 1 degree greater in the HTO than in the TKA group (2.4 vs. 1.4 degrees, < 0.001). The percentage of outliers, defined as a >3 degrees difference between navigation and radiographic MA, was significantly greater preoperatively in the TKA group (37 vs. 10%, < 0.001), but significantly greater postoperatively in the HTO group (28 vs. 10%, < 0.001). The discrepancy between navigation and radiographic measurement of coronal alignment was significantly greater preoperatively in the TKA than in the HTO group, whereas the discrepancy was significantly greater postoperatively in the HTO group.

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The weight-bearing scanogram technique provides better coronal limb alignment than the navigation technique in open high tibial osteotomy

Cited by 67 publications

References 21 publications

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

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

How safe are orthoroentgenograms in determining the amount of correction for varus deformities?

Correlations between Navigation and Radiographic Measures of Alignment

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