Skip to main content
Erschienen in: International Orthopaedics 8/2014

01.08.2014 | Original Paper

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

verfasst von: Cristiano Hossri Ribeiro, Nilson Roberto Severino, Patricia Maria Moraes de Barros Fucs

Erschienen in: International Orthopaedics | Ausgabe 8/2014

Einloggen, um Zugang zu erhalten

Abstract

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.
Literatur
1.
Zurück zum Zitat Coventry MB (1973) Osteotomy about the knee for degenerative and rheumatoid arthritis. J Bone Joint Surg Am 55(1):23–48PubMed Coventry MB (1973) Osteotomy about the knee for degenerative and rheumatoid arthritis. J Bone Joint Surg Am 55(1):23–48PubMed
2.
Zurück zum Zitat Jackson JP, Waugh W (1961) Tibial osteotomy for osteoarthritis of the knee. J Bone Joint Surg Br 43-B:746–751PubMed Jackson JP, Waugh W (1961) Tibial osteotomy for osteoarthritis of the knee. J Bone Joint Surg Br 43-B:746–751PubMed
3.
Zurück zum Zitat Benzakour T, Hefti A, Lemseffer M, El Ahmadi JD, Bouyarmane H, Benzakour A (2010) High tibial osteotomy for medial osteoarthritis of the knee: 15 years follow-up. Int Orthop 34(2):209–215PubMedCentralPubMedCrossRef Benzakour T, Hefti A, Lemseffer M, El Ahmadi JD, Bouyarmane H, Benzakour A (2010) High tibial osteotomy for medial osteoarthritis of the knee: 15 years follow-up. Int Orthop 34(2):209–215PubMedCentralPubMedCrossRef
4.
Zurück zum Zitat Hernigou P, Queinnec S, Picard L, Guissou I, Naanaa T, Duffiet P, Julian D, Archer V (2013) Safety of a novel high tibial osteotomy locked plate fixation for immediate full weight-bearing: a case–control study. Int Orthop 37(12):2377–2384PubMedCrossRef Hernigou P, Queinnec S, Picard L, Guissou I, Naanaa T, Duffiet P, Julian D, Archer V (2013) Safety of a novel high tibial osteotomy locked plate fixation for immediate full weight-bearing: a case–control study. Int Orthop 37(12):2377–2384PubMedCrossRef
5.
Zurück zum Zitat Hsu RW, Himeno S, Coventry MB, Chao EY (1990) Normal axial alignment of the lower extremity and load-bearing distribution at the knee. Clin Orthop Relat Res 255:215–227PubMed Hsu RW, Himeno S, Coventry MB, Chao EY (1990) Normal axial alignment of the lower extremity and load-bearing distribution at the knee. Clin Orthop Relat Res 255:215–227PubMed
6.
Zurück zum Zitat Sharma L, Song J, Felson DT, Cahue S, Shamiyeh E, Dunlop DD (2001) The role of knee alignment in disease progression and functional decline in knee osteoarthritis. JAMA 286(2):188–195PubMedCrossRef Sharma L, Song J, Felson DT, Cahue S, Shamiyeh E, Dunlop DD (2001) The role of knee alignment in disease progression and functional decline in knee osteoarthritis. JAMA 286(2):188–195PubMedCrossRef
7.
Zurück zum Zitat Dugdale TW, Noyes FR, Styer D (1992) Preoperative planning for high tibial osteotomy. The effect of lateral tibiofemoral separation and tibiofemoral length. Clin Orthop Relat Res 274:248–264PubMed Dugdale TW, Noyes FR, Styer D (1992) Preoperative planning for high tibial osteotomy. The effect of lateral tibiofemoral separation and tibiofemoral length. Clin Orthop Relat Res 274:248–264PubMed
8.
Zurück zum Zitat Ribeiro CH, Severino NR, Fucs PM (2013) Preoperative surgical planning versus navigation system in valgus tibial osteotomy: a cross-sectional study. Int Orthop 37(8):1483–1486PubMedCrossRef Ribeiro CH, Severino NR, Fucs PM (2013) Preoperative surgical planning versus navigation system in valgus tibial osteotomy: a cross-sectional study. Int Orthop 37(8):1483–1486PubMedCrossRef
9.
Zurück zum Zitat Dowd GS, Somayaji HS, Uthukuri M (2006) High tibial osteotomy for medial compartment osteoarthritis. Knee 13(2):87–92PubMedCrossRef Dowd GS, Somayaji HS, Uthukuri M (2006) High tibial osteotomy for medial compartment osteoarthritis. Knee 13(2):87–92PubMedCrossRef
10.
Zurück zum Zitat Hernigou P, Medeville D, Debeyre J, Goutallier D (1987) Proximal tibial osteotomy for osteoarthritis with varus deformity. A ten to thirteen-year follow-up study. J Bone Joint Surg Am 69(3):332–354PubMed Hernigou P, Medeville D, Debeyre J, Goutallier D (1987) Proximal tibial osteotomy for osteoarthritis with varus deformity. A ten to thirteen-year follow-up study. J Bone Joint Surg Am 69(3):332–354PubMed
11.
Zurück zum Zitat Sim JA, Kwak JH, Yang SH, Choi ES, Lee BK (2010) Effect of weight-bearing on the alignment after open wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 18(7):874–878PubMedCrossRef Sim JA, Kwak JH, Yang SH, Choi ES, Lee BK (2010) Effect of weight-bearing on the alignment after open wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 18(7):874–878PubMedCrossRef
12.
Zurück zum Zitat Bäthis H, Perlick L, Tingart M, Lüring C, Zurakowski D, Grifka J (2004) Alignment in total knee arthroplasty. A comparison of computer-assisted surgery with the conventional technique. J Bone Joint Surg Br 86(5):682–687PubMedCrossRef Bäthis H, Perlick L, Tingart M, Lüring C, Zurakowski D, Grifka J (2004) Alignment in total knee arthroplasty. A comparison of computer-assisted surgery with the conventional technique. J Bone Joint Surg Br 86(5):682–687PubMedCrossRef
13.
Zurück zum Zitat Goleski P, Warkentine B, Lo D, Gyuricza C, Kendoff D, Pearle AD (2008) Reliability of navigated lower limb alignment in high tibial osteotomies. Am J Sports Med 36(11):2179–2186PubMedCrossRef Goleski P, Warkentine B, Lo D, Gyuricza C, Kendoff D, Pearle AD (2008) Reliability of navigated lower limb alignment in high tibial osteotomies. Am J Sports Med 36(11):2179–2186PubMedCrossRef
14.
Zurück zum Zitat Hankemeier S, Hufner T, Wang G, Kendoff D, Zeichen J, Zheng G et al (2006) Navigated open-wedge high tibial osteotomy: advantages and disadvantages compared to the conventional technique in a cadaver study. Knee Surg Sports Traumatol Arthrosc 14(10):917–921PubMedCrossRef Hankemeier S, Hufner T, Wang G, Kendoff D, Zeichen J, Zheng G et al (2006) Navigated open-wedge high tibial osteotomy: advantages and disadvantages compared to the conventional technique in a cadaver study. Knee Surg Sports Traumatol Arthrosc 14(10):917–921PubMedCrossRef
15.
Zurück zum Zitat Lützner J, Gross AF, Günther KP, Kirschner S (2010) Precision of navigated and conventional open-wedge high tibial osteotomy in a cadaver study. Eur J Med Res 15(3):117–120PubMedCentralPubMedCrossRef Lützner J, Gross AF, Günther KP, Kirschner S (2010) Precision of navigated and conventional open-wedge high tibial osteotomy in a cadaver study. Eur J Med Res 15(3):117–120PubMedCentralPubMedCrossRef
16.
Zurück zum Zitat Kim SJ, Koh YG, Chun YM, Kim YC, Park YS, Sung CH (2009) Medial opening wedge high-tibial osteotomy using a kinematic navigation system versus a conventional method: a 1-year retrospective, comparative study. Knee Surg Sports Traumatol Arthrosc 17(2):128–134PubMedCrossRef Kim SJ, Koh YG, Chun YM, Kim YC, Park YS, Sung CH (2009) Medial opening wedge high-tibial osteotomy using a kinematic navigation system versus a conventional method: a 1-year retrospective, comparative study. Knee Surg Sports Traumatol Arthrosc 17(2):128–134PubMedCrossRef
17.
Zurück zum Zitat Oswald MH, Jakob RP, Schneider E, Hoogewoud HM (1993) Radiological analysis of normal axial alignment of femur and tibia in view of total knee arthroplasty. J Arthroplasty 8(4):419–426PubMedCrossRef Oswald MH, Jakob RP, Schneider E, Hoogewoud HM (1993) Radiological analysis of normal axial alignment of femur and tibia in view of total knee arthroplasty. J Arthroplasty 8(4):419–426PubMedCrossRef
18.
Zurück zum Zitat Fujisawa Y, Masuhara K, Shiomi S (1979) The effect of high tibial osteotomy on osteoarthritis of the knee. An arthroscopic study of 54 knee joints. Orthop Clin North Am 10(3):585–608PubMed Fujisawa Y, Masuhara K, Shiomi S (1979) The effect of high tibial osteotomy on osteoarthritis of the knee. An arthroscopic study of 54 knee joints. Orthop Clin North Am 10(3):585–608PubMed
19.
Zurück zum Zitat Hooper G, Leslie H, Burn J, Schouten R, Beci I (2005) Oblique upper tibial opening wedge osteotomy for genu varum. Oper Orthop Traumatol 17(6):662–673PubMedCrossRef Hooper G, Leslie H, Burn J, Schouten R, Beci I (2005) Oblique upper tibial opening wedge osteotomy for genu varum. Oper Orthop Traumatol 17(6):662–673PubMedCrossRef
20.
Zurück zum Zitat Kawakami H, Sugano N, Yonenobu K, Yoshikawa H, Ochi T, Hattori A et al (2004) Effects of rotation on measurement of lower limb alignment for knee osteotomy. J Orthop Res 22(6):1248–1253PubMedCrossRef Kawakami H, Sugano N, Yonenobu K, Yoshikawa H, Ochi T, Hattori A et al (2004) Effects of rotation on measurement of lower limb alignment for knee osteotomy. J Orthop Res 22(6):1248–1253PubMedCrossRef
21.
Zurück zum Zitat Akamatsu Y, Mitsugi N, Mochida Y, Taki N, Kobayashi H, Takeuchi R et al (2012) Navigated opening wedge high tibial osteotomy improves intraoperative correction angle compared with conventional method. Knee Surg Sports Traumatol Arthrosc 20(3):586–593PubMedCrossRef Akamatsu Y, Mitsugi N, Mochida Y, Taki N, Kobayashi H, Takeuchi R et al (2012) Navigated opening wedge high tibial osteotomy improves intraoperative correction angle compared with conventional method. Knee Surg Sports Traumatol Arthrosc 20(3):586–593PubMedCrossRef
22.
Zurück zum Zitat Giffin JR, Vogrin TM, Zantop T, Woo SL, Harner CD (2004) Effects of increasing tibial slope on the biomechanics of the knee. Am J Sports Med 32(2):376–382PubMedCrossRef Giffin JR, Vogrin TM, Zantop T, Woo SL, Harner CD (2004) Effects of increasing tibial slope on the biomechanics of the knee. Am J Sports Med 32(2):376–382PubMedCrossRef
23.
Zurück zum Zitat Lysholm J, Gillquist J (1982) Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale. Am J Sports Med 10(3):150–154PubMedCrossRef Lysholm J, Gillquist J (1982) Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale. Am J Sports Med 10(3):150–154PubMedCrossRef
24.
Zurück zum Zitat Picardo NE, Khan W, Johnstone D (2012) Computer-assisted navigation in high tibial osteotomy: a systematic review of the literature. Open Orthop J 6:305–312PubMedCentralPubMedCrossRef Picardo NE, Khan W, Johnstone D (2012) Computer-assisted navigation in high tibial osteotomy: a systematic review of the literature. Open Orthop J 6:305–312PubMedCentralPubMedCrossRef
Metadaten
Titel
Opening wedge high tibial osteotomy: navigation system compared to the conventional technique in a controlled clinical study
verfasst von
Cristiano Hossri Ribeiro
Nilson Roberto Severino
Patricia Maria Moraes de Barros Fucs
Publikationsdatum
01.08.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
International Orthopaedics / Ausgabe 8/2014
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-014-2341-y

Weitere Artikel der Ausgabe 8/2014

International Orthopaedics 8/2014 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.