Top

International Orthopaedics

Published in:

01-08-2014 | Original Paper

Opening wedge high tibial osteotomy: navigation system compared to the conventional technique in a controlled clinical study

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

Published in: International Orthopaedics | Issue 8/2014

Abstract

Purpose

This study aimed to verify if the navigation system used in high tibial osteotomy (HTO) adds precision to the procedure regarding mechanical axis correction and prevention of tibial slope increases.

Methods

In this historically controlled study, patients with medial osteoarthrosis and genuvarum underwent HTO between 2004 and 2012; the first 20 were operated with the conventional technique, using pre-planning correction by the Dugdale method and 18 further patients were operated with the navigation system introduced in our hospital.

Results

The two groups were similar for pre-operative mechanical axis (mean 8.10 ± 3.14 for the control and 6.60 ± 2.50 for the navigated group), pre-operative tibial slope (mean 8.95 ± 3.47 versus 8.17 ± 3.11, respectively) and Lyshom score (40.85 ± 15.46 and 44.83 ± 16.86). After surgery, the control group presented mean mechanical axis of 3.35 ± 3.27, tibial slope of 13.75 ± 3.75 and Lyshom score of 87.60 ± 11.12. The navigated group showed a postoperative mechanical axis mean of 3.06 ± 1.70, tibial slope of 10.11 ± 0.18 and Lyshom score of 91.94 ± 11.61.

Conclusions

The navigation system allowed a significantly better control of tibial slope. Patients operated with the navigation system had significantly better Lysholm scores.

Coventry MB (1973) Osteotomy about the knee for degenerative and rheumatoid arthritis. J Bone Joint Surg Am 55(1):23–48PubMed

Jackson JP, Waugh W (1961) Tibial osteotomy for osteoarthritis of the knee. J Bone Joint Surg Br 43-B:746–751PubMed

Benzakour T, Hefti A, Lemseffer M, El Ahmadi JD, Bouyarmane H, Benzakour A (2010) High tibial osteotomy for medial osteoarthritis of the knee: 15 years follow-up. Int Orthop 34(2):209–215PubMedCentralPubMedCrossRef

Hernigou P, Queinnec S, Picard L, Guissou I, Naanaa T, Duffiet P, Julian D, Archer V (2013) Safety of a novel high tibial osteotomy locked plate fixation for immediate full weight-bearing: a case–control study. Int Orthop 37(12):2377–2384PubMedCrossRef

Hsu RW, Himeno S, Coventry MB, Chao EY (1990) Normal axial alignment of the lower extremity and load-bearing distribution at the knee. Clin Orthop Relat Res 255:215–227PubMed

Sharma L, Song J, Felson DT, Cahue S, Shamiyeh E, Dunlop DD (2001) The role of knee alignment in disease progression and functional decline in knee osteoarthritis. JAMA 286(2):188–195PubMedCrossRef

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

Ribeiro CH, Severino NR, Fucs PM (2013) Preoperative surgical planning versus navigation system in valgus tibial osteotomy: a cross-sectional study. Int Orthop 37(8):1483–1486PubMedCrossRef

Dowd GS, Somayaji HS, Uthukuri M (2006) High tibial osteotomy for medial compartment osteoarthritis. Knee 13(2):87–92PubMedCrossRef

10.

Hernigou P, Medeville D, Debeyre J, Goutallier D (1987) Proximal tibial osteotomy for osteoarthritis with varus deformity. A ten to thirteen-year follow-up study. J Bone Joint Surg Am 69(3):332–354PubMed

11.

Sim JA, Kwak JH, Yang SH, Choi ES, Lee BK (2010) Effect of weight-bearing on the alignment after open wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 18(7):874–878PubMedCrossRef

12.

Bäthis H, Perlick L, Tingart M, Lüring C, Zurakowski D, Grifka J (2004) Alignment in total knee arthroplasty. A comparison of computer-assisted surgery with the conventional technique. J Bone Joint Surg Br 86(5):682–687PubMedCrossRef

13.

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

14.

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

15.

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):117–120PubMedCentralPubMedCrossRef

16.

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

17.

Oswald MH, Jakob RP, Schneider E, Hoogewoud HM (1993) Radiological analysis of normal axial alignment of femur and tibia in view of total knee arthroplasty. J Arthroplasty 8(4):419–426PubMedCrossRef

18.

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

19.

Hooper G, Leslie H, Burn J, Schouten R, Beci I (2005) Oblique upper tibial opening wedge osteotomy for genu varum. Oper Orthop Traumatol 17(6):662–673PubMedCrossRef

20.

Kawakami H, Sugano N, Yonenobu K, Yoshikawa H, Ochi T, Hattori A et al (2004) Effects of rotation on measurement of lower limb alignment for knee osteotomy. J Orthop Res 22(6):1248–1253PubMedCrossRef

21.

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

22.

Giffin JR, Vogrin TM, Zantop T, Woo SL, Harner CD (2004) Effects of increasing tibial slope on the biomechanics of the knee. Am J Sports Med 32(2):376–382PubMedCrossRef

23.

Lysholm J, Gillquist J (1982) Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale. Am J Sports Med 10(3):150–154PubMedCrossRef

24.

Picardo NE, Khan W, Johnstone D (2012) Computer-assisted navigation in high tibial osteotomy: a systematic review of the literature. Open Orthop J 6:305–312PubMedCentralPubMedCrossRef

Title: Opening wedge high tibial osteotomy: navigation system compared to the conventional technique in a controlled clinical study
Authors: Cristiano Hossri Ribeiro
Nilson Roberto Severino
Patricia Maria Moraes de Barros Fucs
Publication date: 01-08-2014
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 8/2014
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-014-2341-y

ACC 2024 Congress

Springer Medicine

Opening wedge high tibial osteotomy: navigation system compared to the conventional technique in a controlled clinical study

Abstract

Purpose

Methods

Results

Conclusions

ACC 2024 Congress

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 8/2014

Apolipoprotein E gene E2/E2 genotype is a genetic risk factor for vertebral fractures in humans: a large-scale study

Use of external fixators for damage-control orthopaedics in natural disasters like the 2005 Pakistan earthquake

Excessive polyethylene wear and acetabular bone defects from standard use of a hooded acetabular insert in total hip arthroplasty

Meta-analysis of randomised controlled trials comparing unipolar with bipolar hemiarthroplasty for displaced femoral-neck fractures

Surgery for unilateral and bilateral patellar tendinopathy: a seven year comparative study

Olecranon fractures: factors influencing re-operation