Navigated Versus Conventional Technique in High Tibial Osteotomy: A Meta-Analysis Focusing on Weight Bearing Effect

Overview

Journal Knee Surg Relat Res

Publisher Biomed Central

Date 2019 Mar 22

PMID 30893990

Citations 12

Authors

Kyung Wook Nha

Young-Soo Shin

Hyuk Min Kwon

Jae Ang Sim

Young Gon Na

Affiliations

Soon will be listed here.

Abstract

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.

Citing Articles

Alignment rod and gap measurement methods achieve comparable alignment correction in opening wedge high tibial osteotomy for varus osteoarthritic knees.

Onishi S, Kim Y, Nakayama H, Jacquet C, Mabrouk A, Ollivier M J Exp Orthop. 2024; 11(4):e70038.

PMID: 39415800 PMC: 11480516. DOI: 10.1002/jeo2.70038.

Discharging the medial knee compartment: comparison of pressure distribution and kinematic shifting after implantation of an extra-capsular absorber system (ATLAS) and open-wedge high tibial osteotomy-a biomechanical in vitro analysis.

Kloos F, Becher C, Fleischer B, Ettinger M, Bode L, Schmal H Arch Orthop Trauma Surg. 2022; 143(6):2929-2941.

PMID: 35699755 PMC: 10192192. DOI: 10.1007/s00402-022-04496-0.

Reducing the Risk of Neurovascular Injury With Posteromedial Plating and Laterally Directed Screw Insertion During Opening-Wedge High Tibial Osteotomy.

Shim S, Jeong H, Park S, Lee Y Orthop J Sports Med. 2022; 10(6):23259671221098421.

PMID: 35668870 PMC: 9163734. DOI: 10.1177/23259671221098421.

How to achieve an optimal alignment in medial opening wedge high tibial osteotomy?.

Kang B, Lee D, Kim H, Wang J Knee Surg Relat Res. 2022; 34(1):3.

PMID: 35135631 PMC: 8822774. DOI: 10.1186/s43019-021-00130-2.

Meniscal and Cartilage Changes on Serial MRI After Medial Opening-Wedge High Tibial Osteotomy.

Choi H, Kang Y, Kim J, Lee H, Lee Y Orthop J Sports Med. 2021; 9(12):23259671211047904.

PMID: 34881345 PMC: 8647275. DOI: 10.1177/23259671211047904.

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