Validation of computer-assisted open-wedge high tibial osteotomy using three-dimensional navigation.

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Knee Biomechanics

Background:

• Unintended posterior tibial slope changes after open-wedge high tibial osteotomy (HTO) can negatively impact knee function.
• Accurate control of tibial slope is crucial for restoring knee kinematics and stability post-surgery.

Purpose of the Study:

• To validate the accuracy of three-dimensional (3D) navigation in controlling tibial slope during open-wedge HTO.
• To compare 3D navigation measurements of tibial slope with computed tomography (CT) evaluations.

Main Methods:

• Open-wedge HTO was performed on human cadaver knees using a 3D navigation system.
• The surgical goal was to maintain the pre-operative anatomic tibial slope as guided by the navigation system.
• Tibial slope changes were assessed using both 3D navigation and post-operative CT scans.

Main Results:

• The 3D navigation system successfully maintained the intended anatomic tibial slope during the open-wedge HTO procedure.
• The measurements obtained from 3D navigation correlated well with CT-based evaluations, indicating high accuracy.
• 3D navigation provided reliable intraoperative feedback for tibial slope control.

Conclusions:

• Three-dimensional navigation is a reliable tool for surgeons performing open-wedge HTO.
• It enables precise control over coronal alignment and the maintenance of the anatomic tibial slope.
• Utilizing 3D navigation can enhance surgical outcomes by ensuring accurate tibial slope correction.