Is patient-specific instrumentation more precise than conventional techniques and navigation in achieving planned correction in high tibial osteotomy?
Preoperative planning in high tibial osteotomy (HTO) is a critical step for achieving the desired correction and a clinically satisfactory outcome. Conventional radiography, navigation assistance and patient-specific instrumentation (PSI) are the 3 means of planning, but no prospective studies have...
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creator | Tardy, Nicolas Steltzlen, Camille Bouguennec, Nicolas Cartier, Jean-Loup Mertl, Patrice Batailler, Cécile Hanouz, Jean-Luc Rochcongar, Goulven Fayard, Jean-Marie |
description | Preoperative planning in high tibial osteotomy (HTO) is a critical step for achieving the desired correction and a clinically satisfactory outcome. Conventional radiography, navigation assistance and patient-specific instrumentation (PSI) are the 3 means of planning, but no prospective studies have compared precision between the 3. The aims of the present study were: (1) to analyze and compare correction precision between the 3 planning approaches at 1 year's follow-up; (2) to compare results to those reported in the literature; and (3) to analyze factors influencing the achievement of planned correction.
The study hypothesis was that PSI provides more precise and reproducible planned correction than conventional methods or navigation.
Between June 2017 and June 2018, a multicenter non-randomized prospective observational study was conducted in 11 centers. One hundred and twenty-six patients with Ahlbäck grade I, II or III idiopathic medial tibiofemoral osteoarthritis with stable knee were included and allocated to 3 preoperative planning groups: conventional (group 1), navigation (group 2) and PSI (group 3). Mean age at surgery was 51.2 years (range, 19-69 years; median, 53.2 years); 100 male, 26 female. Complete weight-bearing radiographic work-up was performed preoperatively and at 1 year's follow-up. The PSI group also underwent CT as part of guide production. Target angular correction and mechanical Hip-Knee-Ankle (HKA) axis were set preoperatively. The main endpoint was the difference between planned HKA and HKA at a minimum 12 months.
Mean HKA difference was 1.1±3 in group 1, 2.1±2.6 in group 2 and 0.3±3.1 in group 3. Precision was better with PSI, but not significantly when comparing all 3 groups together. On pairwise intergroup comparison, there was a significant difference only between groups 2 and 3, in favor of PSI (P=0.011).
None of the 3 techniques demonstrated superiority in achieving target correction at 1 year. The study hypothesis was thus not confirmed. All 3 techniques proved reliable and precise in HTO planning.
III, prospective non-randomized comparative study. |
doi_str_mv | 10.1016/j.otsr.2020.08.009 |
format | Article |
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The study hypothesis was that PSI provides more precise and reproducible planned correction than conventional methods or navigation.
Between June 2017 and June 2018, a multicenter non-randomized prospective observational study was conducted in 11 centers. One hundred and twenty-six patients with Ahlbäck grade I, II or III idiopathic medial tibiofemoral osteoarthritis with stable knee were included and allocated to 3 preoperative planning groups: conventional (group 1), navigation (group 2) and PSI (group 3). Mean age at surgery was 51.2 years (range, 19-69 years; median, 53.2 years); 100 male, 26 female. Complete weight-bearing radiographic work-up was performed preoperatively and at 1 year's follow-up. The PSI group also underwent CT as part of guide production. Target angular correction and mechanical Hip-Knee-Ankle (HKA) axis were set preoperatively. The main endpoint was the difference between planned HKA and HKA at a minimum 12 months.
Mean HKA difference was 1.1±3 in group 1, 2.1±2.6 in group 2 and 0.3±3.1 in group 3. Precision was better with PSI, but not significantly when comparing all 3 groups together. On pairwise intergroup comparison, there was a significant difference only between groups 2 and 3, in favor of PSI (P=0.011).
None of the 3 techniques demonstrated superiority in achieving target correction at 1 year. The study hypothesis was thus not confirmed. All 3 techniques proved reliable and precise in HTO planning.
III, prospective non-randomized comparative study.</description><identifier>ISSN: 1877-0568</identifier><identifier>EISSN: 1877-0568</identifier><identifier>DOI: 10.1016/j.otsr.2020.08.009</identifier><identifier>PMID: 32943382</identifier><language>eng</language><publisher>France: Elsevier Masson SAS</publisher><subject>Adult ; Aged ; Female ; High tibial osteotomy ; Humans ; Knee Joint ; Male ; Middle Aged ; Navigation ; Osteoarthritis, Knee - diagnostic imaging ; Osteoarthritis, Knee - surgery ; Osteotomy ; Prospective Studies ; PSI ; Tibia - diagnostic imaging ; Tibia - surgery ; Young Adult</subject><ispartof>Orthopaedics & traumatology, surgery & research, 2020-12, Vol.106 (8), p.S231-S236</ispartof><rights>2020 Elsevier Masson SAS</rights><rights>Copyright © 2020 Elsevier Masson SAS. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c400t-d1b67046b6fe18764554f16b8d26cacb09fdbd7e65ff5cc3e972b54f1c68b3c3</citedby><cites>FETCH-LOGICAL-c400t-d1b67046b6fe18764554f16b8d26cacb09fdbd7e65ff5cc3e972b54f1c68b3c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.otsr.2020.08.009$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32943382$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tardy, Nicolas</creatorcontrib><creatorcontrib>Steltzlen, Camille</creatorcontrib><creatorcontrib>Bouguennec, Nicolas</creatorcontrib><creatorcontrib>Cartier, Jean-Loup</creatorcontrib><creatorcontrib>Mertl, Patrice</creatorcontrib><creatorcontrib>Batailler, Cécile</creatorcontrib><creatorcontrib>Hanouz, Jean-Luc</creatorcontrib><creatorcontrib>Rochcongar, Goulven</creatorcontrib><creatorcontrib>Fayard, Jean-Marie</creatorcontrib><creatorcontrib>Francophone Arthroscopy Society</creatorcontrib><title>Is patient-specific instrumentation more precise than conventional techniques and navigation in achieving planned correction in high tibial osteotomy?</title><title>Orthopaedics & traumatology, surgery & research</title><addtitle>Orthop Traumatol Surg Res</addtitle><description>Preoperative planning in high tibial osteotomy (HTO) is a critical step for achieving the desired correction and a clinically satisfactory outcome. Conventional radiography, navigation assistance and patient-specific instrumentation (PSI) are the 3 means of planning, but no prospective studies have compared precision between the 3. The aims of the present study were: (1) to analyze and compare correction precision between the 3 planning approaches at 1 year's follow-up; (2) to compare results to those reported in the literature; and (3) to analyze factors influencing the achievement of planned correction.
The study hypothesis was that PSI provides more precise and reproducible planned correction than conventional methods or navigation.
Between June 2017 and June 2018, a multicenter non-randomized prospective observational study was conducted in 11 centers. One hundred and twenty-six patients with Ahlbäck grade I, II or III idiopathic medial tibiofemoral osteoarthritis with stable knee were included and allocated to 3 preoperative planning groups: conventional (group 1), navigation (group 2) and PSI (group 3). Mean age at surgery was 51.2 years (range, 19-69 years; median, 53.2 years); 100 male, 26 female. Complete weight-bearing radiographic work-up was performed preoperatively and at 1 year's follow-up. The PSI group also underwent CT as part of guide production. Target angular correction and mechanical Hip-Knee-Ankle (HKA) axis were set preoperatively. The main endpoint was the difference between planned HKA and HKA at a minimum 12 months.
Mean HKA difference was 1.1±3 in group 1, 2.1±2.6 in group 2 and 0.3±3.1 in group 3. Precision was better with PSI, but not significantly when comparing all 3 groups together. On pairwise intergroup comparison, there was a significant difference only between groups 2 and 3, in favor of PSI (P=0.011).
None of the 3 techniques demonstrated superiority in achieving target correction at 1 year. The study hypothesis was thus not confirmed. All 3 techniques proved reliable and precise in HTO planning.
III, prospective non-randomized comparative study.</description><subject>Adult</subject><subject>Aged</subject><subject>Female</subject><subject>High tibial osteotomy</subject><subject>Humans</subject><subject>Knee Joint</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Navigation</subject><subject>Osteoarthritis, Knee - diagnostic imaging</subject><subject>Osteoarthritis, Knee - surgery</subject><subject>Osteotomy</subject><subject>Prospective Studies</subject><subject>PSI</subject><subject>Tibia - diagnostic imaging</subject><subject>Tibia - surgery</subject><subject>Young Adult</subject><issn>1877-0568</issn><issn>1877-0568</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UUtr3DAQFiEl7z_QQ9ExFzuSLMteCJQS2iYQ6CV3ocd4rWUtOZJ2IX8kvzcym5Sccpphvgcz8yH0nZKaEipuNnXIKdaMMFKTviZkdYTOaN91FWlFf_ypP0XnKW0IEYI27ASdNmzFm6ZnZ-j1IeFZZQc-V2kG4wZnsPMpx91UZgUJHk8hAp5jQRPgPCqPTfD7AhdQbXEGM3r3vIOElbfYq71bH4TOY2VGB3vn13jeKu_BFm0sVh_46NYjzk67YhRShpDD9PLzEn0b1DbB1Xu9QE9_fj_d3VeP__4-3P16rAwnJFeWatERLrQYoBwreNvygQrdWyaMMpqsBqttB6IdhtaYBlYd0wvFiF43prlA1wfbOYZl_ywnlwxsy6YQdkkyznnTU067QmUHqokhpQiDnKObVHyRlMglDrmRSxxyiUOSXpY4iujHu_9OT2D_Sz7-Xwi3BwKUI_cOokymZGHAuuVH0gb3lf8bYpOhNQ</recordid><startdate>202012</startdate><enddate>202012</enddate><creator>Tardy, Nicolas</creator><creator>Steltzlen, Camille</creator><creator>Bouguennec, Nicolas</creator><creator>Cartier, Jean-Loup</creator><creator>Mertl, Patrice</creator><creator>Batailler, Cécile</creator><creator>Hanouz, Jean-Luc</creator><creator>Rochcongar, Goulven</creator><creator>Fayard, Jean-Marie</creator><general>Elsevier Masson SAS</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202012</creationdate><title>Is patient-specific instrumentation more precise than conventional techniques and navigation in achieving planned correction in high tibial osteotomy?</title><author>Tardy, Nicolas ; Steltzlen, Camille ; Bouguennec, Nicolas ; Cartier, Jean-Loup ; Mertl, Patrice ; Batailler, Cécile ; Hanouz, Jean-Luc ; Rochcongar, Goulven ; Fayard, Jean-Marie</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c400t-d1b67046b6fe18764554f16b8d26cacb09fdbd7e65ff5cc3e972b54f1c68b3c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Female</topic><topic>High tibial osteotomy</topic><topic>Humans</topic><topic>Knee Joint</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Navigation</topic><topic>Osteoarthritis, Knee - diagnostic imaging</topic><topic>Osteoarthritis, Knee - surgery</topic><topic>Osteotomy</topic><topic>Prospective Studies</topic><topic>PSI</topic><topic>Tibia - diagnostic imaging</topic><topic>Tibia - surgery</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tardy, Nicolas</creatorcontrib><creatorcontrib>Steltzlen, Camille</creatorcontrib><creatorcontrib>Bouguennec, Nicolas</creatorcontrib><creatorcontrib>Cartier, Jean-Loup</creatorcontrib><creatorcontrib>Mertl, Patrice</creatorcontrib><creatorcontrib>Batailler, Cécile</creatorcontrib><creatorcontrib>Hanouz, Jean-Luc</creatorcontrib><creatorcontrib>Rochcongar, Goulven</creatorcontrib><creatorcontrib>Fayard, Jean-Marie</creatorcontrib><creatorcontrib>Francophone Arthroscopy Society</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Orthopaedics & traumatology, surgery & research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tardy, Nicolas</au><au>Steltzlen, Camille</au><au>Bouguennec, Nicolas</au><au>Cartier, Jean-Loup</au><au>Mertl, Patrice</au><au>Batailler, Cécile</au><au>Hanouz, Jean-Luc</au><au>Rochcongar, Goulven</au><au>Fayard, Jean-Marie</au><aucorp>Francophone Arthroscopy Society</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Is patient-specific instrumentation more precise than conventional techniques and navigation in achieving planned correction in high tibial osteotomy?</atitle><jtitle>Orthopaedics & traumatology, surgery & research</jtitle><addtitle>Orthop Traumatol Surg Res</addtitle><date>2020-12</date><risdate>2020</risdate><volume>106</volume><issue>8</issue><spage>S231</spage><epage>S236</epage><pages>S231-S236</pages><issn>1877-0568</issn><eissn>1877-0568</eissn><abstract>Preoperative planning in high tibial osteotomy (HTO) is a critical step for achieving the desired correction and a clinically satisfactory outcome. Conventional radiography, navigation assistance and patient-specific instrumentation (PSI) are the 3 means of planning, but no prospective studies have compared precision between the 3. The aims of the present study were: (1) to analyze and compare correction precision between the 3 planning approaches at 1 year's follow-up; (2) to compare results to those reported in the literature; and (3) to analyze factors influencing the achievement of planned correction.
The study hypothesis was that PSI provides more precise and reproducible planned correction than conventional methods or navigation.
Between June 2017 and June 2018, a multicenter non-randomized prospective observational study was conducted in 11 centers. One hundred and twenty-six patients with Ahlbäck grade I, II or III idiopathic medial tibiofemoral osteoarthritis with stable knee were included and allocated to 3 preoperative planning groups: conventional (group 1), navigation (group 2) and PSI (group 3). Mean age at surgery was 51.2 years (range, 19-69 years; median, 53.2 years); 100 male, 26 female. Complete weight-bearing radiographic work-up was performed preoperatively and at 1 year's follow-up. The PSI group also underwent CT as part of guide production. Target angular correction and mechanical Hip-Knee-Ankle (HKA) axis were set preoperatively. The main endpoint was the difference between planned HKA and HKA at a minimum 12 months.
Mean HKA difference was 1.1±3 in group 1, 2.1±2.6 in group 2 and 0.3±3.1 in group 3. Precision was better with PSI, but not significantly when comparing all 3 groups together. On pairwise intergroup comparison, there was a significant difference only between groups 2 and 3, in favor of PSI (P=0.011).
None of the 3 techniques demonstrated superiority in achieving target correction at 1 year. The study hypothesis was thus not confirmed. All 3 techniques proved reliable and precise in HTO planning.
III, prospective non-randomized comparative study.</abstract><cop>France</cop><pub>Elsevier Masson SAS</pub><pmid>32943382</pmid><doi>10.1016/j.otsr.2020.08.009</doi><oa>free_for_read</oa></addata></record> |
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subjects | Adult Aged Female High tibial osteotomy Humans Knee Joint Male Middle Aged Navigation Osteoarthritis, Knee - diagnostic imaging Osteoarthritis, Knee - surgery Osteotomy Prospective Studies PSI Tibia - diagnostic imaging Tibia - surgery Young Adult |
title | Is patient-specific instrumentation more precise than conventional techniques and navigation in achieving planned correction in high tibial osteotomy? |
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