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High Tibial Osteotomy (HTO)

Purpose

The purpose of high tibial osteotomy is the pain reduction and an increase of the patient’s quality of life. The progressing of the unilateral joint damage has to be prevented and the time to implant an endoprosthesis should be postponed to the future. For very young patients with small unilateral cartilage damage in the knee joint the leg axis is straighten. Cartilage repair procedures can be used supporting the damaged side. For diagnostics and planning of the high tibial osteotomy different x-rays are provided, amongst others an exposure of the entire leg from the hip joint to the ankle joint (full leg exposure). Subsequently the mechanical axis and the gravity of the malposition can be exactly determined. The condition of the joint cartilage and the ligaments can be examined before implementing the osteotomy through an arthroscopy (joint endoscopy).

The OrthoPilot® navigation system is an ideal amendment with the correction of the leg axis. It indicates the individual structures to the operating surgeon, in order to support him with the execution of axis correcting maneuvers and the ideal positioning of the POSITION HTO plate.
Compared to many other systems the OrthoPilot® navigation system is abandoned from additional image-guided preliminary analysis of the patient. Therefore there are no exposure doses by CT-scans.

The substantial advantage for the patient is the accuracy during the execution of the axis correcting maneuvers and the positioning of the POSITION HTO plate. Thus the condition for a permanent correction and a good joint function is created.

A varus malposition of the tibia (bow leg) frequently leads to an unilateral medial cartilage damage in the knee. Therefore an operational correction (high tibial osteotomy) at the tibial head is accomplished. With the opening technology (opening wedge) a cut near the joint is positioned and slowly opened by wedge profile. By special plates the opened gap is kept stable, until it's bony marbled. The degree of correction is computed exactly by the OrthoPilot® navigation system and shown at the screen. The accurate correction of the leg axis is an important factor for a good operation result. In the case of using the OrthoPilot® navigation system the movement of the femur and tibia and the certain reference points at the leg measured, provide an image of the leg axis. During the surgery the surgeon can exactly control and document at any time, how the gap size in the tibia affects the leg axis. Thus a precise correction of the leg malposition is reached.