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Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
Published on: January 24, 2018
Navigated opening wedge high tibial osteotomy improves intraoperative correction angle compared with conventional
Y Akamatsu1, N Mitsugi, Y Mochida
1Department of Orthopedic Surgery, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan. akamatsu@yokohama-cu.ac.jp
Summary
Navigation-assisted opening wedge high tibial osteotomy (HTO) improves coronal and sagittal plane accuracy. This technique may reduce undercorrection in unstable knees, leading to better femoro-tibial angles and tibial posterior slopes.
Area of Science:
- Orthopedic surgery
- Biomechanical engineering
- Surgical navigation systems
Background:
- Accurate correction angles in high tibial osteotomy (HTO) are crucial for successful outcomes.
- Preoperative planning and intraoperative technique significantly influence the final correction.
- Opening wedge HTO is a common procedure for treating knee osteoarthritis and malalignment.
Purpose of the Study:
- To investigate whether a navigation system improves intraoperative target angles in the coronal and sagittal planes during opening wedge HTO.
- To compare the accuracy of navigated HTO with the conventional method.
Main Methods:
- A comparative study involving 28 knees treated with navigated opening wedge HTO and 31 knees treated with conventional HTO.
- Assessment of postoperative femoro-tibial angle (FTA) and tibial posterior slope (TPS).
- Intraoperative correction angle determination varied between groups: predicted medial opening width (conventional) vs. change in hip-knee-ankle angle (navigated).
Main Results:
- The navigated HTO group showed a significantly higher mean postoperative FTA compared to the conventional group (P < 0.037).
- The navigated group demonstrated a smaller mean change in TPS (P = 0.001).
- In cases of lateral cortex breakage or tibial plateau fracture, the navigated group achieved a mean FTA of 170.3°, potentially reducing undercorrection compared to the conventional group (174.6°).
Conclusions:
- Navigation systems in opening wedge HTO may enhance intraoperative accuracy for both FTA and TPS.
- This technology could be particularly beneficial in reducing undercorrection in knees with lateral instability.
- Navigated HTO offers a promising approach for achieving more precise correction in high tibial osteotomy procedures.
