Advertisement

More accurate correction can be obtained using a three-dimensional printed model in open-wedge high tibial osteotomy

  • Hee-June Kim
  • Jaeyeong Park
  • Ji-Yeon Shin
  • Il-Hyung Park
  • Kyeong-Hyeon Park
  • Hee-Soo Kyung
Knee
  • 181 Downloads

Abstract

Purpose

The purpose of this study was to compare the accuracy of the preoperative planning method using a three-dimensional (3D) printed model with that of a method using picture archiving and communication system (PACS) images in high tibial osteotomy (HTO).

Methods

Patients who underwent HTO using a 3D printed model (20 patients) and a method based on PACS images (20 patients) from 2012 to 2016 were compared. After obtaining the correction angle, in the 3D printed method, the wedge-shaped 3D printed model was designed. The PACS method used preoperative radiographs. The accuracy of HTO for each method was compared using radiographs obtained at the first postoperative year. The preoperative and postoperative posterior tibial slope angles were also compared.

Results

The weight-bearing line was corrected 21.2 ± 11.8% from preoperatively to 61.6 ± 3.3% postoperatively in the 3D group and from 19.4 ± 12.3% to 61.3 ± 8.1% in the PACS group. The mean absolute difference with the target point was lower in the 3D group (2.3 ± 2.5) than in the PACS group (6.2 ± 5.1; p = 0.005). The number of patients in an acceptable range was higher in the 3D group than in the PACS group. The posterior tibial slope angle was not significantly different in the 3D group (8.6°–8.9°), but was significantly different in the PACS group (9.9°–10.5°, p = 0.042).

Conclusions

In open-wedge HTO, a more accurate correction for successful results could be obtained using the 3D printed model.

Level of evidence

IV.

Keywords

3D printing High tibial osteotomy Picture archiving and communication system 

Notes

Funding

This study received no funding to complete.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the institutional review board (IRB) of Kyungpook National University Hospital (IRB no. KNUH 2016-12-030-002).

Informed consent

Patients gave informed consent prior to study inclusion.

References

  1. 1.
    Amendola A, Bonasia DE (2010) Results of high tibial osteotomy: review of the literature. Int Orthop 34(2):155–160CrossRefPubMedGoogle Scholar
  2. 2.
    Brouwer RW, Bierma-Zeinstra SM, van Koeveringe AJ, Verhaar JA (2005) Patellar height and the inclination of the tibial plateau after high tibial osteotomy. The open versus the closed-wedge technique. J Bone Jt Surg Br 87(9):1227–1232CrossRefGoogle Scholar
  3. 3.
    Coventry MB (1965) Osteotomy of the upper portion of the tiba for degenerative arthritis of the knee. A preliminary report. J Bone Jt Surg Am 47:984–990CrossRefGoogle Scholar
  4. 4.
    Coventry MB (1985) Upper tibial osteotomy for osteoarthritis. J Bone Jt Surg Am 67(7):1136–1140CrossRefGoogle Scholar
  5. 5.
    El-Azab H, Halawa A, Anetzberger H, Imhoff AB, Hinterwimmer S (2008) The effect of closed- and open-wedge high tibial osteotomy on tibial slope: a retrospective radiological review of 120 cases. J Bone Jt Surg Br 90(9):1193–1197CrossRefGoogle Scholar
  6. 6.
    Fujisawa Y, Masuhara K, Shiomi S (1979) The effect of high tibial osteotomy on osteoarthritis of the knee. An arthroscopic study of 54 knee joints. Orthop Clin N Am 10(3):585–608Google Scholar
  7. 7.
    Hernigou P, Medevielle D, Debeyre J, Goutallier D (1987) Proximal tibial osteotomy for osteoarthritis with varus deformity. A ten to thirteen-year follow-up study. J Bone Jt Surg Am 69(3):332–354CrossRefGoogle Scholar
  8. 8.
    Kettelkamp DB, Wenger DR, Chao EY, Thompson C (1976) Results of proximal tibial osteotomy. The effects of tibiofemoral angle, stance-phase flexion-extension, and medial-plateau force. J Bone Jt Surg Am 58(7):952–960CrossRefGoogle Scholar
  9. 9.
    Kwun JD, Kim HJ, Park J, Park IH, Kyung HS (2017) Open wedge high tibial osteotomy using three-dimensional printed models: experimental analysis using porcine bone. Knee 24(1):16–22CrossRefPubMedGoogle Scholar
  10. 10.
    Lee DC, Byun SJ (2012) High tibial osteotomy. Knee Surg Relat Res 24(2):61–69CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Lee YS, Kim MK, Byun HW, Kim SB, Kim JG (2015) Reliability of the imaging software in the preoperative planning of the open-wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 23(3):846–851CrossRefPubMedGoogle Scholar
  12. 12.
    Lutzner J, Gross AF, Gunther KP, Kirschner S (2009) Reliability of limb alignment measurement for high tibial osteotomy with a navigation system. Eur J Med Res 14(10):447–450CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Marx RG, Grimm P, Lillemoe KA, Robertson CM, Ayeni OR, Lyman S, Bogner EA, Pavlov H (2011) Reliability of lower extremity alignment measurement using radiographs and PACS. Knee Surg Sports Traumatol Arthrosc 19(10):1693–1698CrossRefPubMedGoogle Scholar
  14. 14.
    Miniaci A, Ballmer FT, Ballmer PM, Jakob RP (1989) Proximal tibial osteotomy. A new fixation device. Clin Orthop Relat Res (246):250–259Google Scholar
  15. 15.
    Pérez-Mañanes R, Burró JA, Manaute JR, Rodriguez FC, Martín JV (2016) 3d surgical printing cutting guides for open-wedge high tibial osteotomy: do it yourself. J Knee Surg 29(08):690–695CrossRefPubMedGoogle Scholar
  16. 16.
    Pape D, Seil R, Adam F, Rupp S, Kohn D, Lobenhoffer P (2004) Imaging and preoperative planning of osteotomy of tibial head osteotomy. Orthopade 33(2):122–134CrossRefPubMedGoogle Scholar
  17. 17.
    Peters PG, Laughlin RT, Markert RJ, Nelles DB, Randall KL, Prayson MJ (2012) Timing of C-arm drape contamination. Surg Infect (Larchmt) 13(2):110–113CrossRefGoogle Scholar
  18. 18.
    Poukens J, Haex J, Riediger D (2003) The use of rapid prototyping in the preoperative planning of distraction osteogenesis of the cranio-maxillofacial skeleton. Comput Aided Surg 8(3):146–154CrossRefPubMedGoogle Scholar
  19. 19.
    Ribeiro CH, Severino NR, Fucs PM (2013) Preoperative surgical planning versus navigation system in valgus tibial osteotomy: a cross-sectional study. Int Orthop 37(8):1483–1486CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Song EK, Seon JK, Park SJ, Jeong MS (2010) The complications of high tibial osteotomy: closing-versus opening-wedge methods. J Bone Jt Surg Br 92(9):1245–1252CrossRefGoogle Scholar
  21. 21.
    Sprenger TR, Doerzbacher JF (2003) Tibial osteotomy for the treatment of varus gonarthrosis. Survival and failure analysis to twenty-two years. J Bone Jt Surg Am 85(3):469–474CrossRefGoogle Scholar
  22. 22.
    Starosolski ZA, Kan JH, Rosenfeld SD, Krishnamurthy R, Annapragada A (2014) Application of 3-D printing (rapid prototyping) for creating physical models of pediatric orthopedic disorders. Pediatr Radiol 44(2):216–221CrossRefPubMedGoogle Scholar
  23. 23.
    Tjornstrand B, Egund N, Hagstedt B, Lindstrand A (1981) Tibial osteotomy in medial gonarthrosis. The importance of over-correction of varus deformity. Arch Orthop Trauma Surg 99(2):83–89CrossRefPubMedGoogle Scholar
  24. 24.
    Wilde F, Cornelius C-P, Schramm A (2014) Computer-assisted mandibular reconstruction using a patient-specific reconstruction plate fabricated with computer-aided design and manufacturing techniques. Craniomaxillofac Trauma Reconstr 7(2):158–166CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Wu XB, Wang JQ, Zhao CP, Sun X, Shi Y, Zhang ZA, Li YN, Wang MY (2015) Printed three-dimensional anatomic templates for virtual preoperative planning before reconstruction of old pelvic injuries: initial results. Chin Med J (Engl) 128(4):477–482CrossRefGoogle Scholar
  26. 26.
    Yoon SD, Zhang G, Kim HJ, Lee BJ, Kyung HS (2016) Comparison of cable method and miniaci method using picture archiving and communication system in preoperative planning for open wedge high tibial osteotomy. Knee Surg Relat Res 28(4):283–288CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2018

Authors and Affiliations

  • Hee-June Kim
    • 1
  • Jaeyeong Park
    • 2
  • Ji-Yeon Shin
    • 3
  • Il-Hyung Park
    • 1
  • Kyeong-Hyeon Park
    • 1
  • Hee-Soo Kyung
    • 1
  1. 1.Department of Orthopaedic Surgery, School of MedicineKyungpook National University, Kyungpook National University HospitalDaeguSouth Korea
  2. 2.School of Mechanical EngineeringYeungjin CollegeDaeguSouth Korea
  3. 3.Department of Preventive Medicine, School of MedicineKyungpook National UniversityDaeguSouth Korea

Personalised recommendations