Computer-Assisted Navigation in High Tibial Osteotomy: A Systematic Review of the Literature

Picardo, Natasha E.; Khan, Wasim; Johnstone, David

doi:10.2174/1874325001206010305

Cited by 31 publications

(17 citation statements)

References 45 publications

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“…In a recent systematic review about the navigation technique, Picardo et al [24] found only two studies comparing the conventional and the navigation techniques, evaluating the mechanical axes, tibial slope and the clinical results, both very similar to our study. The mechanical axis was better controlled, but the tibial slope and the clinical evaluation were different.…”

Section: Discussionsupporting

confidence: 87%

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

Ribeiro

Severino

Fucs

2014

International Orthopaedics (SICOT)

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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.

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Section: Discussionsupporting

confidence: 87%

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

Ribeiro

Severino

Fucs

2014

International Orthopaedics (SICOT)

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“…There are also technique-related disadvantages, such as the long learning curve, line of sight issues, registration failures, and mechanical or software malfunctions 1). Gebhard et al16) reported on the influence of surgeon's experience and perioperative complications in computer-assisted open-wedge HTO.…”

Section: Disadvantages and Literature Reviewmentioning

confidence: 99%

“…High tibial osteotomy (HTO) is a procedure that realigns the weight-bearing line from the affected medial compartment to the relatively unaffected lateral compartment of the knee 1). Interest in HTO as an adjunctive procedure has increased recently due to technical advances in cartilage healing procedures and meniscal transplantation for which malalignment would otherwise represent a contraindication.…”

mentioning

confidence: 99%

Computer-Assisted Navigation in High Tibial Osteotomy

Song

Bae

2016

Clin Orthop Surg

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Computer-assisted navigation is used to improve the accuracy and precision of correction angles during high tibial osteotomy. Most studies have reported that this technique reduces the outliers of coronal alignment and unintended changes in the tibial posterior slope angle. However, more sophisticated studies are necessary to determine whether the technique will improve the clinical results and long-term survival rates. Knowledge of the navigation technology, surgical techniques and potential pitfalls, the clinical results of previous studies, and understanding of the advantages and limitations of the computer-assisted navigation are crucial to successful application of this new technique in high tibial osteotomy. Herein, we review the evidence concerning this technique from previous studies.

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“…The most common procedure in use is high tibial osteotomy (HTO) and was introduced in 1958. 30,31 Due to the common presentation of varus malalignment in young, active patients with medial osteoarthritis the osteotomy is typically conducted as a medial opening wedge osteotomy. Multiple fixation techniques are established.…”

Section: Navigation In Osteotomymentioning

confidence: 99%