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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.
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