Navigation vs. conventional high tibial osteotomy: systematic review

Abstract

IntroductionOne major use for high tibial osteotomy aims at improving alignment in the symptomatic, varus malaligned, medial compartment osteoarthritic knee. The importance of achieving correct alignment is obvious upon considering the increased potential for significant complications with over-or undercorrection in any plane. The aim of this systematic review was to compare navigation and conventional high tibial osteotomy. Materials and methodsThis systematic review searched the MEDLINE and EMBASE databases to compare the short-term clinical and radiological outcomes between patients undergoing either conventional or navigated high tibial osteotomy. ResultsWe retrieved 52 articles, which ultimately resulted in nine eligible studies for inclusion. Though heterogeneity prevented statistical analysis, only one study failed to suggest superiority of navigation over conventional techniques. Conclusion Navigated high tibial osteotomy improves accuracy over conventional techniques, though the current best evidence presented herein must be advanced by higher quality studies.

Outcome reporting following navigated high tibial osteotomy of the knee: a systematic review

“…The ability to reliably and consistently produce the necessary corrective cuts and alignment adjustment is a longstanding challenge in HTO procedures [26]. Conventional methods have relied on techniques such as preoperative radiographs, cables and lines, osteotomy jigs, and intraoperative mapping grids; however, these methods rely on static planning and are limited by multiplanar deformity that typically exits [4, 26, 43]. Navigational and computer‐assisted techniques allow for surgeons to obtain dynamic measurements of leg alignment intraoperatively in three dimensions which allows for immediate correction.…”