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Title: Computer assisted alignment of opening wedge high tibial osteotomy provides limited improvement of radiographic outcomes compared to flouroscopic alignment.
Authors: Stanley, Jeremy
Robinson, Kerian
Devitt, Brian
Richmond, Anneka
Whitehead, Timothy
Feller, Julian
Other Authors: Webster, Kate
Keywords: Orthopaedics
High Tibial Osteotomy
Radiographic Outcomes
Computer navigation
Limb Alignment
Medial Opening Wedge
Varus Deformity
Sports Medicine
Sports Injury
Athletic Injuries
Medial Opening Wedge High Tibial Osteotomy
Musculoskeletal Clinical Institute, Epworth HealthCare, Victoria, Australia
Issue Date: Mar-2016
Publisher: Elsevier
Citation: Knee. 2016 Mar;23(2):289-94. Epub 2016 Jan 18.
Abstract: INTRODUCTION: There are numerous methods available to assist surgeons in the accurate correction of varus alignment during medial opening wedge high tibial osteotomy (MOWHTO). Preoperative planning performed with radiographs or more recently intraoperative computer navigation software has been used. The aim of the study was to compare the accuracy of computer navigated versus non-navigated techniques to correct varus alignment of the knee. METHOD: The preoperative and postoperative radiographs of 117 knees that underwent MOWHTO were investigated to assess radiographic limb alignment 12-months postoperatively. The desired correction was defined as a weight bearing line (Mikulicz point {MP}) 58% of the width of the tibial plateau from the medial tibial margin. Sixty-five knees were corrected using a conventional technique and 52 knees were corrected using computer navigation. RESULTS: The mean MP percentage was 59% in the navigated group, compared with 56% in the fluoroscopic group (p=0.183). 51.9% of the navigation knees were corrected to within five percent of the desired correction, in contrast to 38.5% of the fluoroscopically corrected knees (p=0.15). 71.2% of the navigated knees were corrected to within 10% of the desired correction, compared with 63.1% of the fluoroscopically corrected knees (p=0.36). Large preoperative deformities were more accurately corrected with navigation assistance (57% vs 49%, p=0.049). CONCLUSION: No statistically significant difference was found in the radiographic correction of varus alignment twelve months postoperatively between navigated and fluoroscopic techniques of MOWHTO. However, a subgroup analysis demonstrated that larger preoperative varus deformities may be more accurately corrected using computer navigation.
DOI: 10.1016/j.knee.2015.12.006
PubMed URL:
ISSN: 0968-0160
Journal Title: Knee
Type: Journal Article
Affiliated Organisations: School of Allied Health, College of Science, Health and Engineering La Trobe University, Bundoora, Victoria, Australia.
Type of Clinical Study or Trial: Retrospective studies
Appears in Collections:Musculoskeletal

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