Cristiano Hossri Ribeiro1, Mauricio Sante Bettio Mod2, Daniel Isch3, Clemens Baier4, Guenther Maderbacher4, Nilson Roberto Severino5, Daniele Cristina Cataneo6. 1. Knee Surgery Division, Hospital Orto, Av. Nove de Julho, 1017, Vila Icaraí, São José dos Campos, SP, 12243-690, Brazil. alelorenti@yahoo.com.br. 2. Ápice Clinic, Sorocaba, SP, Brazil. 3. Safrima, Bern, Switzerland. 4. Asklepios Klinik, Bad Abbach, Germany. 5. Department of Orthopedics and Traumatology, Santa Casa de Misericórdia de São Paulo (SCSP), São Paulo, Brazil. 6. Surgery and Orthopaedics Department, Universidade Estadual de São Paulo (Unesp), Botucatu, SP, Brazil.
Abstract
INTRODUCTION: The complications of the open-wedge osteotomy technique (slope, hypo- and hypercorrection and fractures) are related to difficulties in the control of the open-wedge angle during surgery. MATERIALS AND METHODS: In this cadaveric study, we evaluated the safety and precision of a novel system, the Realignment High Control System (RHC), in the correction of knee mechanical axis and slope. The RHC has a fixation plate coupled to a dynamic device that opens the osteotomy continuously, allowing plate fixation before osteotomy wedge opening. RESULTS: All procedures were easily performed, with no fractures. The openings equaled the indicated by the navigation system for 7.5° and 10°, and for 5°, there was a statistically, although not clinically significant, difference of 0.6°. The slope shown by the RHC setting and in the navigation system was significantly different for the 10° setting only, with a mean difference of 0.563°. CONCLUSIONS: RHC facilitates the surgical technique of high tibial osteotomy, with gradual wedge opening, precise correction of the mechanical axis, and appropriate control of the tibial slope, even with larger openings.
INTRODUCTION: The complications of the open-wedge osteotomy technique (slope, hypo- and hypercorrection and fractures) are related to difficulties in the control of the open-wedge angle during surgery. MATERIALS AND METHODS: In this cadaveric study, we evaluated the safety and precision of a novel system, the Realignment High Control System (RHC), in the correction of knee mechanical axis and slope. The RHC has a fixation plate coupled to a dynamic device that opens the osteotomy continuously, allowing plate fixation before osteotomy wedge opening. RESULTS: All procedures were easily performed, with no fractures. The openings equaled the indicated by the navigation system for 7.5° and 10°, and for 5°, there was a statistically, although not clinically significant, difference of 0.6°. The slope shown by the RHC setting and in the navigation system was significantly different for the 10° setting only, with a mean difference of 0.563°. CONCLUSIONS: RHC facilitates the surgical technique of high tibial osteotomy, with gradual wedge opening, precise correction of the mechanical axis, and appropriate control of the tibial slope, even with larger openings.