Department of Orthopaedic Surgery, University Hospital Carl Gustav Carus, Medical Faculty of the Technical University of Dresden, Germany.
Eur J Med Res. 2010 Mar 30;15(3):117-20. doi: 10.1186/2047-783x-15-3-117.
High tibial osteotomy (HTO) is an established treatment option for isolated medial osteoarthritis in young and active patients. One important factor for success of this procedure is the degree of correction of the weight-bearing line. Computer-assisted navigation systems are believed to improve the precision of axis correction through intraoperative real-time monitoring. This study investigates the precision of correction of the weight-bearing line in open-wedge HTO with and without a navigation system. Nineteen legs of well-preserved human cadaver were randomly assigned to navigated (n = 10) or conventional (n = 9) HTO. In order to achieve a sufficient amount of correction in all legs the weight-bearing line was aimed at 80 percent of the width of the tibial plateau. The mean deviation of the weight-bearing line from the desired 80 percent was 1 percent in the navigated and 8.6 percent in the conventional operated legs (p = 0.002). The weight-bearing line of all navigated but only 5 of the 9 conventional operated legs was within a +/- 5 percent tolerance level (p = 0.33). Navigated open-wedge HTO achieved better correction of the weight-bearing line than the conventional method in human cadaver legs. Future studies have to prove this advantage in a clinical setting and it's effect on patient outcome.
胫骨高位截骨术（HTO）是治疗年轻且活跃的内侧单间室骨关节炎的一种成熟的治疗选择。该手术成功的一个重要因素是负重线的矫正程度。计算机辅助导航系统被认为可以通过术中实时监测提高轴矫正的精度。本研究调查了导航辅助与非导航辅助开放式楔形 HTO 对线矫正精度的差异。19 条保存完好的人体下肢标本被随机分配到导航组（n=10）或传统组（n=9）。为了使所有下肢获得足够的矫正量，将负重线对准胫骨平台宽度的 80%。导航组的负重线与期望的 80%的偏差平均值为 1%，而传统组为 8.6%（p=0.002）。所有导航组的负重线都在+/-5%的容差范围内，但只有 9 条传统组中的 5 条负重线在容差范围内（p=0.33）。导航辅助开放式楔形 HTO 比传统方法在人体下肢标本中对线矫正的效果更好。未来的研究需要在临床环境中证明这一优势及其对患者结果的影响。
