The weight-bearing scanogram technique provides better coronal limb alignment than the navigation technique in open high tibial osteotomy

Knee. 2014 Mar;21(2):451-5. doi: 10.1016/j.knee.2012.09.003. Epub 2012 Oct 5.


Background: Successful outcomes following high tibial osteotomy (HTO) require precise realignment of the mechanical axis of the lower extremity. The present study investigated whether the weight-bearing limb scanogram (WBS) technique provided a more accurate mechanical axis realignment than the navigation technique in open high tibial osteotomy (OHTO).

Methods: This prospective study involved 80 knees (78 patients) undergoing OHTO. The WBS technique was used in 40 knees and the navigation technique in 40 knees. Each technique was performed by a different surgeon in a different hospital. Postoperative coronal limb alignment was assessed using the weight-bearing line (WBL) ratio on full-length standing hip-to-ankle radiographs.

Results: We found that the mean postoperative WBL ratio was greater in the WBS compared to the navigation group (p=0.001), and hence the ratio for the WBS group was closer to the ratio target of 62%. There was a greater proportion of WBL ratio outliers in the navigation group than the WBS group (25% vs. 10%, p=0.034).

Conclusion: We conclude that the WBS technique was more accurate than the navigation technique for restoration of coronal leg alignment in OHTO.

Level of evidence: Level II.

Keywords: Accuracy; Navigation; Open high tibial osteotomy; Weight-bearing limb scanography.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Female
  • Humans
  • Joint Deformities, Acquired / etiology
  • Joint Deformities, Acquired / surgery*
  • Lower Extremity / diagnostic imaging*
  • Lower Extremity / physiology
  • Male
  • Middle Aged
  • Osteoarthritis, Knee / complications
  • Osteoarthritis, Knee / surgery
  • Osteotomy / methods*
  • Preoperative Period
  • Prospective Studies
  • Radiography
  • Surgery, Computer-Assisted*
  • Tibia / surgery*
  • Weight-Bearing / physiology*