Purpose: We aimed to determine whether navigated opening wedge high tibial osteotomy (HTO) is superior to the conventional technique in terms of accuracy of the coronal and sagittal alignment correction, functional outcome, and operative time.
Methods: Studies comparing navigated and conventional HTO were included in this meta-analysis. We compared the incidence of radiological outliers in coronal alignment and tibial slope maintenance, mean differences in functional outcome scales, and operative time. Subgroup analyses were performed on coronal alignment accuracy based on the intraoperative method of alignment confirmation: fluoroscopy vs. gap measurement method.
Results: Twelve studies were included: there were 434 knees in the navigated HTO studies and 405 knees in the conventional HTO studies. The risk of outlier was lower in navigated HTO than in conventional HTO; however, the difference was not significant when navigated HTO was compared with conventional HTO performed using the gap measurement method. Tibial slope maintenance was comparable or better in navigated HTO. No difference was found in the American Knee Society function and Lysholm scores. Navigated HTO necessitated a longer operative time of approximately 10 minutes.
Conclusions: The use of navigation in HTO can improve accuracy in both coronal and sagittal alignments, but its clinical benefit is unclear.
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http://dx.doi.org/10.5792/ksrr.17.090 | DOI Listing |
Orthop Surg
December 2024
Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China.
Background: High tibial osteotomy (HTO) is a surgical procedure for treating certain knee conditions. Proper execution of HTO can preserve joint function and delay or avoid the need for total knee replacement. This study compared different 3D printing techniques (fused deposition modeling, selective laser sintering, and direct metal laser sintering) and a navigation system for their suitability in assisting HTO surgeries.
View Article and Find Full Text PDFAnn Med Surg (Lond)
September 2024
Departments of Orthopaedics.
Background: High tibial osteotomy (HTO) is a well-established surgical procedure employed to treat medial compartment knee osteoarthritis by modifying the mechanical axis of the lower limb, thereby reducing the load on the affected joint. It has gained increased attention in recent years, resulting in numerous research advancements in this field.
Methods: The top 100 most-cited papers on HTO, published between 1970 and 2023, were identified by searching the Web of Science Core Collection database.
Arthroplasty
August 2024
Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
Background: This study introduced an Augmented Reality (AR) navigation system to address limitations in conventional high tibial osteotomy (HTO). The objective was to enhance precision and efficiency in HTO procedures, overcoming challenges such as inconsistent postoperative alignment and potential neurovascular damage.
Methods: The AR-MR (Mixed Reality) navigation system, comprising HoloLens, Unity Engine, and Vuforia software, was employed for pre-clinical trials using tibial sawbone models.
Knee Surg Relat Res
December 2023
Department of Orthopaedic Surgery, Kyung Hee University College of Medicine, Kyung Hee University Medical Center, 26 Kyunghee-Daero, Dongdaemun-Gu, Seoul, 02447, Korea.
Background: Although intraoperative navigation can improve the surgeon's proficiency, no studies have analyzed postoperative outcomes of high tibial osteotomy (HTO) after computer-assisted surgery (CAS) experience. The present study compared the clinical and radiographic results between conventional and CAS closed-wedge (CW) HTOs after CAS experience.
Methods: Each of the 50 conventional and CAS CW HTOs performed by single surgeon between 2015 and 2017 were included.
Knee
December 2022
Department of Orthopedics and Sports Medicine, The First Affiliated Hospital of Soochow University, Suzhou, PR China. Electronic address:
Background: To compare and analyze the correction precision, clinical outcomes and complications among the three methods of performing open-wedge high tibial osteotomy (HTO), including patient-specific instrumentation (PSI), conventional method and navigation assistance.
Methods: In this prospective, single-center study, we randomly assigned patients with knee osteoarthritis in a 1:1:1 ratio to undergo Open-wedge high tibial osteotomy (OWHTO) with conventional method, navigation assistance or PSI. The primary outcome was the target/observed hip-knee-ankle (HKA) angle difference at 1 month postoperatively.
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