Computer aided high tibial open wedge osteotomy

Keppler, Peter; Gebhard, Florian; Grützner, Paul A.; Wang, Gongli; Zheng, Guoyan; Hüfner, Tobias; Hankemeier, Stefan; Nolte, Lutz-Peter (2004). Computer aided high tibial open wedge osteotomy. Injury - international journal of the care of the injured, 35(1), pp. 68-78. Elsevier 10.1016/j.injury.2004.05.013

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High tibial osteotomy is a widely accepted treatment of medial compartment osteoarthritis as well as other lower extremity deformities. However, it is a technically demanding procedure. The lack of exact intraoperative real time control of the mechanical axis often results in postoperative malalignments, which is one reason for poor long term results. These problems can be addressed with the use of a surgical navigation system. Following exposure, dynamic reference bases (DRBs) are attached to the femur, and the proximal and the distal part of the tibia. After intraoperative measurement of the deformities and correction planning, the osteotomy is performed under navigational guidance. The wedge size, joint line orientation, and tibial plateau slope are monitored during correction. The in vitro evaluation with a plastic bone model suggests that the error of deformity correction is less than 1.7 degrees (95% confidence limits) in the frontal, and less than 2.3 degrees (95% confidence limits) in the sagittal plane, respectively. On a cadaver study of 13 legs, the mechanical axis intersected the Fujisawa line in 80.7% (range 77.5-85.8%). The preliminary clinical experience confirms these results. A novel computer tomography free navigation system for high tibial osteotomy has been developed that holds the promise of improving the accuracy, reliability, and safety of this kind of approach.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Pre-clinic Human Medicine > Institute for Surgical Technology & Biomechanics ISTB [discontinued]
UniBE Contributor:	Wang, Gongli, Zheng, Guoyan, Nolte, Lutz-Peter
Subjects:	500 Science > 570 Life sciences; biology 600 Technology > 610 Medicine & health
ISSN:	0020-1383
Publisher:	Elsevier
Language:	English
Submitter:	Guoyan Zheng
Date Deposited:	26 Jul 2017 14:33
Last Modified:	05 Dec 2022 14:56
Publisher DOI:	10.1016/j.injury.2004.05.013
PubMed ID:	15183706
URI:	https://boris.unibe.ch/id/eprint/82196