Comparison of Two-Dimensional and Three-Dimensional Preoperative Planning Measurements for High Tibial Osteotomy

Area of Science:

• Orthopedics
• Biomechanics
• Surgical Planning

Background:

• Knee osteoarthritis (KOA) is a common degenerative joint disease causing pain and disability.
• Open-wedge high tibial osteotomy (OWHTO) is an effective surgical treatment for unicompartmental KOA, aiming to correct lower limb alignment.
• Accurate preoperative planning is crucial for successful OWHTO outcomes.

Purpose of the Study:

• To compare the correction angles and distraction distances between 2D and 3D preoperative planning methods for OWHTO.
• To evaluate the impact of different planning modalities on surgical outcomes in KOA patients.
• To provide insights into optimizing surgical strategies for OWHTO.

Main Methods:

• Retrospective analysis of 102 patients with medial knee OA undergoing OWHTO.
• Comparison of 2D and 3D preoperative planning techniques targeting a 62.5% weight-bearing line (%WBL).
• Quantitative assessment of differences in correction angles and distraction distances using statistical tests.

Main Results:

• The 2D planning approach resulted in a significantly larger mean correction angle (1.49° ± 1.70°) compared to the 3D approach (p < 0.001).
• The medial opening gap in OWHTO was wider with 2D planning (2.1 ± 2.06 mm difference).
• Both methods aimed for the same %WBL target.

Conclusions:

• 2D preoperative planning for OWHTO requires a greater correction angle and medial opening gap than 3D planning for equivalent alignment.
• Surgeons should be aware of these planning discrepancies to minimize potential correction errors.
• Consideration of 2D vs. 3D planning differences is vital for successful OWHTO strategizing.