High tibial osteotomy a good application for computerized navigation

Link  http://www.orthosupersite.com/view.asp?rID=25741

1st on the web (January 17, 2008)
January 2008

LAHAINA, Hawaii - With more orthopedic surgeons showing a renewed interest in high tibial osteotomy, some are finding that they can do it effectively using computerized navigation.

"The one place where I think navigation offers a good possibility for us is the high tibial osteotomy," Douglas W. Jackson, MD, said at Orthopedics Today Hawaii 2008. "I am talking about the opening wedge or medial wedge."

Jackson, course director and Chief Medical Editor of Orthopedics Today, said orthopedists are performing more of these procedures as a result of malalignment seen in patients undergoing microfracture, osteochondral grafting (auto and allografts), chondrocyte transplantation, meniscal transplantation and ACL reconstruction with medial compartment degenerative joint disease.

He said that if a surgeon is unfamiliar with navigation, he or she should have an experienced colleague walk them through it, but if a surgeon has been using navigation for knees, it should be an easy change.

"In the operating room, [navigation] lets me know where the center of the hip is and what the angle is. It allows me to see exactly what the patient's alignment is on the table," Jackson said.

Once he has registered the bony landmarks into the system, he can individualize in each patient exactly where he wants the axis to go through the knee.

"It also allows me to do the hinge where the wedge is opened very accurately ... it tells me the exact length to leave the 5-mm hinge and fine-tune the slope of the osteotomy," he said.

Jackson said he uses navigation with the less-severe deformities, since correcting more than 1 cm can result in delayed healing in many instances.

For more information:

Jackson DW. Osteotomy and navigation. Presented at Orthopedics Today Hawaii 2008. Jan. 13-16, 2008. Lahaina, Maui, Hawaii.