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Meta-Analysis
. 2017:2017:3803457.
doi: 10.1155/2017/3803457. Epub 2017 Oct 9.

Effect of Computer Navigation on Accuracy and Reliability of Limb Alignment Correction following Open-Wedge High Tibial Osteotomy: A Meta-Analysis

Seung-Beom Han  1 , Hyun Jung Kim  2 , Dae-Hee Lee  3
Affiliations
Meta-Analysis

Effect of Computer Navigation on Accuracy and Reliability of Limb Alignment Correction following Open-Wedge High Tibial Osteotomy: A Meta-Analysis

Seung-Beom Han et al. Biomed Res Int. 2017.

Abstract

Background: It is unclear whether computer navigation can improve the accuracy and reliability of targeted lower limb alignment correction following open-wedge high tibial osteotomy (HTO). This meta-analysis was designed to compare the accuracy and reliability of limb alignment correction between computer navigated and conventional open-wedge HTOs.

Methods: Studies that compared postoperative coronal alignment, including mechanical axis (MA) and weight bearing line (WBL) ratio, outliers of alignment correction, and change in tibial posterior slope, following open-wedge HTO performed using computer navigated and conventional methods were included.

Results: Ten studies were included in the meta-analysis. The MA (0.93°; 95% confidence interval [CI]: 0.45-1.41°; P < 0.001) and WBL ratio (1.5%; 95% CI: 0.03-2.98%; P = 0.048) were significantly greater for computer navigated HTO than for conventional HTO. Outliers of alignment correction after surgery were significantly lower in patients who underwent computer navigated HTO than in those who underwent conventional HTO (odds ratio: 0.25; 95% CI: 0.08-0.79; P = 0.02). Changes in posterior tibial slope from before to after surgery, however, were similar for the two approaches.

Conclusion: Computer navigated HTO resulted in slightly more valgus postoperative alignment and effectively reduced outliers of alignment correction but had no effect on change in posterior tibial slope when compared with conventional HTO.

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Figures

Figure 1
Figure 1
PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) flow diagram of the identification and selection of the studies included in this meta-analysis.
Figure 2
Figure 2
Forest plot showing the mean differences in coronal alignments, including mechanical axis and weight bearing line ratio, between computer navigated and conventional high tibial osteotomies.
Figure 3
Figure 3
Forest plot showing the proportion of outliers of alignment (>±3°) between computer navigated and conventional high tibial osteotomies.
Figure 4
Figure 4
Forest plot showing the mean differences in posterior tibial slope between computer navigated and conventional high tibial osteotomies.
See this image and copyright information in PMC

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