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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

Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA
|July 30, 2011
PubMed
Summary

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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).

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  • 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.