Technical accuracy in high tibial osteotomy for gonarthrosis

Area of Science:

• Orthopedic surgery
• Radiology
• Biomechanics

Background:

• Medial compartment osteoarthritis of the knee is a common condition.
• High tibial osteotomy (HTO) is a surgical procedure to correct knee alignment.
• Accurate preoperative planning is crucial for successful HTO outcomes.

Purpose of the Study:

• To present a preoperative roentgenological analysis of the whole leg in standing position as an aid for HTO.
• To evaluate the method's ability to assess knee mechanical alignment, deformity extent, and bone wedge size.
• To report initial clinical experience and outcomes with this preoperative analysis.

Main Methods:

• Whole leg radiography in standing position was performed preoperatively.
• Analysis focused on mechanical axis, deformity, and planned bone wedge excision for HTO.
• Sixty-six HTO procedures were analyzed retrospectively.

Main Results:

• The preoperative analysis provided essential data for surgical planning.
• Eighty percent (four-fifths) of osteotomies achieved postoperative correction within +/- 3 degrees of the predicted angle.
• Two-thirds of patients maintained this correction range at the 1-year follow-up.

Conclusions:

• Preoperative whole leg standing radiography is a valuable tool for planning high tibial osteotomy.
• This method aids in determining the precise bone wedge for correction, improving accuracy.
• The technique demonstrates encouraging initial results for achieving and maintaining knee alignment in osteoarthritis patients.