Dae-Hee Lee1, Seoung-Bum Han2, Kwang-Jun Oh3, Jun Seop Lee4, Jae-Ho Kwon5, Jong-In Kim5, Smarajit Patnaik5, Gautam M Shetty5, Kyung-Wook Nha6. 1. Department of Orthopaedic Surgery, Inje University, Ilsanpaik Hospital, Ilsan, Korea; Department of Orthopaedic Surgery, Korea University, Anam Hospital, Seoul, Korea. 2. Department of Orthopaedic Surgery, Korea University, Anam Hospital, Seoul, Korea. 3. Department of Orthopaedic Surgery, Konkuk University Medical Center, Seoul, Korea. 4. Department of Orthopaedic Surgery, Gumdan Top Hospital, Incheon, Korea. 5. Department of Orthopaedic Surgery, Inje University, Ilsanpaik Hospital, Ilsan, Korea. 6. Department of Orthopaedic Surgery, Inje University, Ilsanpaik Hospital, Ilsan, Korea. Electronic address: kwnhamj@hotmail.com.
Abstract
BACKGROUND: Successful outcomes following high tibial osteotomy (HTO) require precise realignment of the mechanical axis of the lower extremity. The present study investigated whether the weight-bearing limb scanogram (WBS) technique provided a more accurate mechanical axis realignment than the navigation technique in open high tibial osteotomy (OHTO). METHODS: This prospective study involved 80 knees (78 patients) undergoing OHTO. The WBS technique was used in 40 knees and the navigation technique in 40 knees. Each technique was performed by a different surgeon in a different hospital. Postoperative coronal limb alignment was assessed using the weight-bearing line (WBL) ratio on full-length standing hip-to-ankle radiographs. RESULTS: We found that the mean postoperative WBL ratio was greater in the WBS compared to the navigation group (p=0.001), and hence the ratio for the WBS group was closer to the ratio target of 62%. There was a greater proportion of WBL ratio outliers in the navigation group than the WBS group (25% vs. 10%, p=0.034). CONCLUSION: We conclude that the WBS technique was more accurate than the navigation technique for restoration of coronal leg alignment in OHTO. LEVEL OF EVIDENCE: Level II.
BACKGROUND: Successful outcomes following high tibial osteotomy (HTO) require precise realignment of the mechanical axis of the lower extremity. The present study investigated whether the weight-bearing limb scanogram (WBS) technique provided a more accurate mechanical axis realignment than the navigation technique in open high tibial osteotomy (OHTO). METHODS: This prospective study involved 80 knees (78 patients) undergoing OHTO. The WBS technique was used in 40 knees and the navigation technique in 40 knees. Each technique was performed by a different surgeon in a different hospital. Postoperative coronal limb alignment was assessed using the weight-bearing line (WBL) ratio on full-length standing hip-to-ankle radiographs. RESULTS: We found that the mean postoperative WBL ratio was greater in the WBS compared to the navigation group (p=0.001), and hence the ratio for the WBS group was closer to the ratio target of 62%. There was a greater proportion of WBL ratio outliers in the navigation group than the WBS group (25% vs. 10%, p=0.034). CONCLUSION: We conclude that the WBS technique was more accurate than the navigation technique for restoration of coronal leg alignment in OHTO. LEVEL OF EVIDENCE: Level II.
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