Miscorrection in coronal plane osteotomies around the knee-Current concepts

Area of Science:

• Orthopedic surgery
• Biomechanical engineering
• Surgical outcomes research

Background:

• Osteotomy surgery for knee deformities (varus/valgus) is complex.
• Miscalignment (miscorrection) can occur despite surgical efforts.
• Understanding contributing factors is crucial for improving patient outcomes.

Purpose of the Study:

• To review and enhance understanding of miscorrection following knee osteotomy.
• To identify key factors in planning, surgical technique, and rehabilitation that influence miscorrection.
• To explore current methods for preventing miscorrection and suggest future research directions.

Main Methods:

• Comprehensive review of scientific literature.
• Inclusion of expert consensual information from European projects.
• Analysis of planning parameters like Joint Line Convergence Angle and Obliquity.
• Comparison of Computer Assisted Navigation (CAS) and Patient-Specific Instrumentation (PSI).

Main Results:

• Miscalignment involves multiple interrelated factors beyond simple coronal plane inaccuracy.
• Planning parameters (correction level, Joint Line Convergence Angle, Joint Line Obliquity) are relevant.
• Technological advancements (CAS, PSI) and techniques (hinge wire protection) aim to reduce miscorrection.
• Clarification of definitions: target, surgical accuracy, accuracy range, and tolerance.

Conclusions:

• Individualized planning is essential for each patient undergoing knee osteotomy.
• No single correction target suits all knee conditions.
• Further research is needed, with potential for Artificial Intelligence (AI) to aid analysis and future study design.