title: The weight-bearing scanogram technique provides better coronal limb alignment than the navigation technique in open high tibial osteotomy.
abstract: 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).
  
  
  CONCLUSIONS
  We conclude that the WBS technique was more accurate than the navigation technique for restoration of coronal leg alignment in OHTO.
  
  
  METHODS
  Level II.
authors.affiliation: Department of Orthopaedic Surgery, Inje University, Ilsanpaik Hospital, Ilsan, Korea; Department of Orthopaedic Surgery, Korea University, Anam Hospital, Seoul, Korea.
authors.forename: Dae-Hee
authors.initials: DH
authors.lastname: Lee
authors.affiliation: Department of Orthopaedic Surgery, Korea University, Anam Hospital, Seoul, Korea.
authors.forename: Seoung-Bum
authors.initials: SB
authors.lastname: Han
authors.affiliation: Department of Orthopaedic Surgery, Konkuk University Medical Center, Seoul, Korea.
authors.forename: Kwang-Jun
authors.initials: KJ
authors.lastname: Oh
authors.affiliation: Department of Orthopaedic Surgery, Gumdan Top Hospital, Incheon, Korea.
authors.forename: Jun Seop
authors.initials: JS
authors.lastname: Lee
authors.affiliation: Department of Orthopaedic Surgery, Inje University, Ilsanpaik Hospital, Ilsan, Korea.
authors.forename: Jae-Ho
authors.initials: JH
authors.lastname: Kwon
authors.affiliation: Department of Orthopaedic Surgery, Inje University, Ilsanpaik Hospital, Ilsan, Korea.
authors.forename: Jong-In
authors.initials: JI
authors.lastname: Kim
authors.affiliation: Department of Orthopaedic Surgery, Inje University, Ilsanpaik Hospital, Ilsan, Korea.
authors.forename: Smarajit
authors.initials: S
authors.lastname: Patnaik
authors.affiliation: Department of Orthopaedic Surgery, Inje University, Ilsanpaik Hospital, Ilsan, Korea.
authors.forename: Gautam M
authors.initials: GM
authors.lastname: Shetty
authors.affiliation: Department of Orthopaedic Surgery, Inje University, Ilsanpaik Hospital, Ilsan, Korea. Electronic address: kwnhamj@hotmail.com.
authors.forename: Kyung-Wook
authors.initials: KW
authors.lastname: Nha
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D016916:Joint Deformities, Acquired / Q000209:etiology / Q000601:surgery*; D035002:Lower Extremity / Q000000981:diagnostic imaging* / Q000502:physiology; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000150:complications / Q000601:surgery; D010027:Osteotomy / Q000379:methods*; D057234:Preoperative Period; D011446:Prospective Studies; D011859:Radiography; D025321:Surgery, Computer-Assisted; D013977:Tibia / Q000601:surgery*; D016474:Weight-Bearing / Q000502:physiology*