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NAVIGATED OPEN WEDGE HIGH TIBIAL OSTEOTOMY FOR GONARTHROSIS



Abstract

Long term successful results of high tibial osteotomy (HTO) strongly depend on the degree of correction, and inadequate intraoperative measurements of the leg axis can lead to under or over correction, and surgeons have to solve these problems based on personal experience.

This study was undertaken to investigate and compare the clinical and radiological results of navigation assisted open wedge high tibial osteotomy (HTO) versus conventional HTO at 12 months after surgery, for unicompartmental gonarthrosis.

Forty navigated open HTOs with an anterior opening gap of approximately 70% of the posterior gap were included and compared with forty open HTOs performed using the conventional cable technique in terms of intraoperative leg axis assess.

Navigated HTOs corrected mechanical axes to 2.9° valgus (range 0.5–6.2) with few outliers (12.5%), and maintained posterior slopes (7.9±2.3° preoperatively and 8.3±2.8° postoperatively) (P> 0.05). However, in the conventional group, only 63% of cases were within the satisfactory range (valgus 2–5°), and tendencies toward undercorrection and an increase in posterior slope were observed. Clinically both groups showed satisfactory results.

Navigated HTO significantly improved the accuracy of postoperative mechanical axis and decreased correction variabilities with fewer outliers.

Correspondence should be addressed to Mr K Deep, General Secretary CAOS UK, Dept of Orthopaedics, Golden Jubilee National Hospital, Glasgow G81 4HX, Scotland. Email: caosuk@gmail.com