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Published in: International Orthopaedics 8/2013

01-08-2013 | Original Paper

Preoperative surgical planning versus navigation system in valgus tibial osteotomy: a cross-sectional study

Authors: Cristiano Hossri Ribeiro, Nilson Roberto Severino, Patricia Maria de Moraes Barros Fucs

Published in: International Orthopaedics | Issue 8/2013

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Abstract

Purpose

The objective of this study was to verify whether the correction obtained using a navigation system (NS) corresponds to the wedge calculated by the Dugdale method (DM) in high tibial osteotomy (HTO).

Methods

We included 17 patients with primary varus and HTO indication, consecutively admitted to a public university hospital. All patients underwent panoramic radiography with bipedal load for the wedge calculation by DM. They underwent HTO with an opening wedge, fixed with an HTO plate and monitored by the OrthoPilot NS. Bone grafts were used in every case. The wedge opening obtained by the NS was compared to that calculated in the radiographs.

Results

The mean opening by DM was 9.53° and by the NS 11.8° (p < 0.045).

Conclusions

There was a significant difference in the calculation of the wedge opening between the DM and NS. HTO without the aid of the NS could theoretically lead to undercorrection of the deformity.
Literature
1.
go back to reference Marti CB, Gautier E, Wachtl SW, Jakob RP (2004) Accuracy of frontal and sagittal plane correction in open-wedge high tibial osteotomy. Arthroscopy 20(4):366–372PubMedCrossRef Marti CB, Gautier E, Wachtl SW, Jakob RP (2004) Accuracy of frontal and sagittal plane correction in open-wedge high tibial osteotomy. Arthroscopy 20(4):366–372PubMedCrossRef
2.
go back to reference Esenkaya I, Elmali N (2006) Proximal tibia medial open-wedge osteotomy using plates with wedges: early results in 58 cases. Knee Surg Sports Traumatol Arthrosc 14(10):955–961PubMedCrossRef Esenkaya I, Elmali N (2006) Proximal tibia medial open-wedge osteotomy using plates with wedges: early results in 58 cases. Knee Surg Sports Traumatol Arthrosc 14(10):955–961PubMedCrossRef
3.
go back to reference Insall JN, Joseph DM, Msika C (1984) High tibial osteotomy for varus gonarthrosis. A long-term follow-up study. J Bone Joint Surg Am 66(7):1040–1048PubMed Insall JN, Joseph DM, Msika C (1984) High tibial osteotomy for varus gonarthrosis. A long-term follow-up study. J Bone Joint Surg Am 66(7):1040–1048PubMed
4.
go back to reference Puddu G, Franco V (2000) Femoral antivalgus opening wedge osteotomy. Oper Tech Sports Med 8(1):56–60CrossRef Puddu G, Franco V (2000) Femoral antivalgus opening wedge osteotomy. Oper Tech Sports Med 8(1):56–60CrossRef
5.
go back to reference Lobenhoffer P, Agneskirchner JD (2003) Improvements in surgical technique of valgus high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 11(3):132–138PubMed Lobenhoffer P, Agneskirchner JD (2003) Improvements in surgical technique of valgus high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 11(3):132–138PubMed
6.
go back to reference Amendola A (2003) Unicompartmental osteoarthritis in the active patient: the role of high tibial osteotomy. Arthroscopy 19(Suppl 1):109–116PubMed Amendola A (2003) Unicompartmental osteoarthritis in the active patient: the role of high tibial osteotomy. Arthroscopy 19(Suppl 1):109–116PubMed
7.
go back to reference Gebhard F, Krettek C, Hüfner T, Grützner PA, Stöckle U, Imhoff AB et al (2011) Reliability of computer-assisted surgery as an intraoperative ruler in navigated high tibial osteotomy. Arch Orthop Trauma Surg 131(3):297–302PubMedCrossRef Gebhard F, Krettek C, Hüfner T, Grützner PA, Stöckle U, Imhoff AB et al (2011) Reliability of computer-assisted surgery as an intraoperative ruler in navigated high tibial osteotomy. Arch Orthop Trauma Surg 131(3):297–302PubMedCrossRef
8.
go back to reference Kendoff D, Citak M, Pearle A, Gardner MJ, Hankemeier S, Krettek C et al (2007) Influence of lower limb rotation in navigated alignment analysis: implications for high tibial osteotomies. Knee Surg Sports Traumatol Arthrosc 15(8):1003–1008PubMedCrossRef Kendoff D, Citak M, Pearle A, Gardner MJ, Hankemeier S, Krettek C et al (2007) Influence of lower limb rotation in navigated alignment analysis: implications for high tibial osteotomies. Knee Surg Sports Traumatol Arthrosc 15(8):1003–1008PubMedCrossRef
9.
go back to reference Dugdale TW, Noyes FR, Styer D (1992) Preoperative planning for high tibial osteotomy. The effect of lateral tibiofemoral separation and tibiofemoral length. Clin Orthop Relat Res 274:248–264PubMed Dugdale TW, Noyes FR, Styer D (1992) Preoperative planning for high tibial osteotomy. The effect of lateral tibiofemoral separation and tibiofemoral length. Clin Orthop Relat Res 274:248–264PubMed
10.
go back to reference Ribeiro CH, Severino NR, Cury Rde P, de Oliveira VM, Avakian R, Ayhara T et al (2009) A new fixation material for open-wedge tibial osteotomy for genu varum. Knee 16(5):366–370PubMedCrossRef Ribeiro CH, Severino NR, Cury Rde P, de Oliveira VM, Avakian R, Ayhara T et al (2009) A new fixation material for open-wedge tibial osteotomy for genu varum. Knee 16(5):366–370PubMedCrossRef
11.
go back to reference Lo WN, Cheung KW, Yung SH, Chiu KH (2009) Arthroscopy-assisted computer navigation in high tibial osteotomy for varus knee deformity. J Orthop Surg (Hong Kong) 17(1):51–55 Lo WN, Cheung KW, Yung SH, Chiu KH (2009) Arthroscopy-assisted computer navigation in high tibial osteotomy for varus knee deformity. J Orthop Surg (Hong Kong) 17(1):51–55
12.
go back to reference Iorio R, Vadalà A, Giannetti S, Pagnottelli M, Di Sette P, Conteduca F et al (2010) Computer-assisted high tibial osteotomy: preliminary results. Orthopedics 33(10 Suppl):82–86PubMedCrossRef Iorio R, Vadalà A, Giannetti S, Pagnottelli M, Di Sette P, Conteduca F et al (2010) Computer-assisted high tibial osteotomy: preliminary results. Orthopedics 33(10 Suppl):82–86PubMedCrossRef
13.
go back to reference Saragaglia D, Mercier N, Colle PE (2010) Computer-assisted osteotomies for genu varum deformity: which osteotomy for which varus? Int Orthop 34(2):185–190PubMedCrossRef Saragaglia D, Mercier N, Colle PE (2010) Computer-assisted osteotomies for genu varum deformity: which osteotomy for which varus? Int Orthop 34(2):185–190PubMedCrossRef
14.
go back to reference Ahlbäck S (1968) Osteoarthrosis of the knee. A radiographic investigation. Acta Radiol Diagn (Stockh) Suppl 277:7–72 Ahlbäck S (1968) Osteoarthrosis of the knee. A radiographic investigation. Acta Radiol Diagn (Stockh) Suppl 277:7–72
15.
go back to reference Fujisawa Y, Masuhara K, Shiomi S (1979) The effect of high tibial osteotomy on osteoarthritis of the knee. An arthroscopic study of 54 knee joints. Orthop Clin North Am 10(3):585–608PubMed Fujisawa Y, Masuhara K, Shiomi S (1979) The effect of high tibial osteotomy on osteoarthritis of the knee. An arthroscopic study of 54 knee joints. Orthop Clin North Am 10(3):585–608PubMed
16.
go back to reference Liodakis E, Kenawey M, Liodaki E, Mommsen P, Krettek C, Hankemeier S (2010) The axis-board: an alternative to the cable technique for intraoperative assessment of lower limb alignment. Technol Health Care 18(3):165–171PubMed Liodakis E, Kenawey M, Liodaki E, Mommsen P, Krettek C, Hankemeier S (2010) The axis-board: an alternative to the cable technique for intraoperative assessment of lower limb alignment. Technol Health Care 18(3):165–171PubMed
17.
go back to reference Goleski P, Warkentine B, Lo D, Gyuricza C, Kendoff D, Pearle AD (2008) Reliability of navigated lower limb alignment in high tibial osteotomies. Am J Sports Med 36(11):2179–2186PubMedCrossRef Goleski P, Warkentine B, Lo D, Gyuricza C, Kendoff D, Pearle AD (2008) Reliability of navigated lower limb alignment in high tibial osteotomies. Am J Sports Med 36(11):2179–2186PubMedCrossRef
18.
go back to reference Lützner J, Gross AF, Günther KP, Kirschner S (2009) Reliability of limb alignment measurement for high tibial osteotomy with a navigation system. Eur J Med Res 14(10):447–450PubMedCrossRef Lützner J, Gross AF, Günther KP, Kirschner S (2009) Reliability of limb alignment measurement for high tibial osteotomy with a navigation system. Eur J Med Res 14(10):447–450PubMedCrossRef
19.
go back to reference Demange MK, Camanho GL, Pécora JR, Gobbi RG, Tirico LE, da Mota e Albuquerque RF (2011) Simultaneous anterior cruciate ligament reconstruction and computer-assisted open-wedge high tibial osteotomy: a report of eight cases. Knee 18(6):387–391PubMedCrossRef Demange MK, Camanho GL, Pécora JR, Gobbi RG, Tirico LE, da Mota e Albuquerque RF (2011) Simultaneous anterior cruciate ligament reconstruction and computer-assisted open-wedge high tibial osteotomy: a report of eight cases. Knee 18(6):387–391PubMedCrossRef
20.
go back to reference Kim SJ, Koh YG, Chun YM, Kim YC, Park YS, Sung CH (2009) Medial opening wedge high-tibial osteotomy using a kinematic navigation system versus a conventional method: a 1-year retrospective, comparative study. Knee Surg Sports Traumatol Arthrosc 17(2):128–134PubMedCrossRef Kim SJ, Koh YG, Chun YM, Kim YC, Park YS, Sung CH (2009) Medial opening wedge high-tibial osteotomy using a kinematic navigation system versus a conventional method: a 1-year retrospective, comparative study. Knee Surg Sports Traumatol Arthrosc 17(2):128–134PubMedCrossRef
21.
go back to reference Lützner J, Gross AF, Günther KP, Kirschner S (2010) Precision of navigated and conventional open-wedge high tibial osteotomy in a cadaver study. Eur J Med Res 15(3):117–120PubMedCrossRef Lützner J, Gross AF, Günther KP, Kirschner S (2010) Precision of navigated and conventional open-wedge high tibial osteotomy in a cadaver study. Eur J Med Res 15(3):117–120PubMedCrossRef
22.
go back to reference Akamatsu Y, Mitsugi N, Mochida Y, Taki N, Kobayashi H, Takeuchi R et al (2012) Navigated opening wedge high tibial osteotomy improves intraoperative correction angle compared with conventional method. Knee Surg Sports Traumatol Arthrosc 20(3):586–593PubMedCrossRef Akamatsu Y, Mitsugi N, Mochida Y, Taki N, Kobayashi H, Takeuchi R et al (2012) Navigated opening wedge high tibial osteotomy improves intraoperative correction angle compared with conventional method. Knee Surg Sports Traumatol Arthrosc 20(3):586–593PubMedCrossRef
23.
go back to reference Noyes FR, Goebel SX, West J (2005) Opening wedge tibial osteotomy: the 3-triangle method to correct axial alignment and tibial slope. Am J Sports Med 33(3):378–387PubMedCrossRef Noyes FR, Goebel SX, West J (2005) Opening wedge tibial osteotomy: the 3-triangle method to correct axial alignment and tibial slope. Am J Sports Med 33(3):378–387PubMedCrossRef
24.
go back to reference Hankemeier S, Hufner T, Wang G, Kendoff D, Zeichen J, Zheng G et al (2006) Navigated open-wedge high tibial osteotomy: advantages and disadvantages compared to the conventional technique in a cadaver study. Knee Surg Sports Traumatol Arthrosc 14(10):917–921PubMedCrossRef Hankemeier S, Hufner T, Wang G, Kendoff D, Zeichen J, Zheng G et al (2006) Navigated open-wedge high tibial osteotomy: advantages and disadvantages compared to the conventional technique in a cadaver study. Knee Surg Sports Traumatol Arthrosc 14(10):917–921PubMedCrossRef
25.
go back to reference Maurer F, Wassmer G (2006) High tibial osteotomy: does navigation improve results? Orthopedics 29(10 Suppl):S130–S132PubMed Maurer F, Wassmer G (2006) High tibial osteotomy: does navigation improve results? Orthopedics 29(10 Suppl):S130–S132PubMed
26.
go back to reference Song EK, Seon JK, Park SJ (2007) How to avoid unintended increase of posterior slope in navigation-assisted open-wedge high tibial osteotomy. Orthopedics 30(10 Suppl):S127–S131PubMed Song EK, Seon JK, Park SJ (2007) How to avoid unintended increase of posterior slope in navigation-assisted open-wedge high tibial osteotomy. Orthopedics 30(10 Suppl):S127–S131PubMed
Metadata
Title
Preoperative surgical planning versus navigation system in valgus tibial osteotomy: a cross-sectional study
Authors
Cristiano Hossri Ribeiro
Nilson Roberto Severino
Patricia Maria de Moraes Barros Fucs
Publication date
01-08-2013
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 8/2013
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-013-1960-z

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