Results and Survivorship of High Tibial Osteotomy

Closed-wedge high tibial osteotomy using computer-assisted surgery compared to the conventional technique

“…This gender distribution of osteoarthritis is a common finding in Korean ethnic groups, caused by the racial difference of disease demographics and gender distinction of the incidence of bow leg deformity. 6 Our post-operative mechanical axis and mechanical axis percentage measurements on the radiographs were less than those under navigation guidance by as much as 1.5°( SD 2.3) and 3.6% (SD 10.2). This difference could occur because the post-operative mechanical axis and mechanical axis percentage with the navigation system were measured with patients in a supine position, and the post-operative radiographs were taken in a weight-bearing standing position.…”

“…On the other hand, too medial a placement will weaken the medial cortex, which may result in instability of the fixation and loss of correction. 6,18 With the conventional technique it is difficult to accurately control the hinge position even with the jig system, because it can only control the wedge size. Three-dimensional orientation of the wedge is important because asymmetrical closure could introduce unwanted secondary deformity, such as malrotation in the transverse plane or alteration of the posterior slope angle in the sagittal plane.…”

“…3 Advantages of the lateral closed-wedge osteotomy include the presence of broad metaphyseal opposing surfaces, offering quicker healing 1 and negating the risk of loss of correction, fixation failure, delayed union and nonunion and satisfactory long-term results have been reported. [4][5][6][7][8] However, there are potential risks of neurovascular injury and of creating additional difficulty when converting a knee with a previous osteotomy to a total knee replacement (TKR). 9,10 Several long-term studies indicate that accurate correction has been the leading predictor for success.…”

“…9,10 Several long-term studies indicate that accurate correction has been the leading predictor for success. [4][5][6]10 Conventional methods for determining the correction angle and wedge size include pre-operative radiological measurement and planning, intra-operative measurement with the help of a cable, grids with lead-impregnated reference lines, and a system that uses a jig. 4,11 However, it is difficult to obtain the ideal correction with conventional techniques because of the unreliability of preoperative planning.…”