High Tibial Osteotomy Planning with Anatomical Models

A high tibial osteotomy (HTO) is a surgical procedure that realigns the knee joint by cutting and repositioning the tibia (shinbone) to correct alignment problems and relieve pressure on the knee, often used to treat medial compartment osteoarthritis and malalignment. HTO aims to correct angular deformities (like bowleggedness or knock-knees) of the knee, which can lead to uneven weight distribution and increased stress on one side of the joint, causing pain and cartilage damage that may eventually lead to knee arthroplasty. It is increasingly becoming a more popular surgical procedure that can intervene without the need for a full knee replacement.

In HTO, the surgeons makes precise cuts and removes a wedge of bone, before the leg is 'realigned' by opening or closing the gap where the wedge of bone is removed, the bone is then secured with bone plates allowing it to regenerate to this new alignment.

Key to HTO is the surgical planning of which is traditionally done in 2 dimensions. This method, however, has limitations and does not always allow for the best results. the 2D planning does not allow the clinician to fully appreciate rotational and out of plane deformities.

Anatomical models and digital software allows for this planning to be done digitally and in 3D. This past month we assisted a private clinic in Singapore to produce a full length life size anatomical model to plan for this surgery. The model was produced wth FDM technology to keep costs low.