Table 1.

Clinical Studies Examining the Outcomes of Navigation in High Tibial Osteotomy

Study Group	Type of Study	No of Patients	Follow-Up	Navigation System	Internal Fixation	Findings	Complications Related to Navigation
Wang 2005 [38]	Case series at two centres; navigated open, closed and dome osteotomy	31	12 weeks	Surgigate	Not stated	26 patients treated successfully with good correction of coronal alignment	5 technical problems leading to conversion to conventional technique
Saragaglia & Roberts 2005 [47]	Comparative study comparing navigated and conventional OWHTO	56 (28 in each group)	Post operative	Orthopilot	AO T-plate	Navigated group – better correction of mechanical axis; better reproducibility	No mention
Baur & Schuh 2006 [46]	Case series navigated OWHTO	54	Post operative	Orthopilot	Not stated	Good correction of mechanical axis; good reproducibility	Haematoma of distal pin track
Maurer &Wassmer 2006 [6]	Comparative study – navigated v conventional OWHTO	67 (23 navigated, 44 conventional)	Post operative	Orthopilot	Synthes Tomofix	Navigated group – better correction of mechanical axis, better reproducibility. Operation time 10 mins longer in navigated group	None
Song 2007 [48]	Case series navigated OWHTO	40	3 months	Orthopilot	B Braun Aesculap open wedge plate	Good correction of mechanical axis, posterior tibial slope maintained	None
Kim 2009 [40]	Comparative study – navigated v conventional OWHTO	85 (90 knees; 43 conventional, 47 navigated)	1 year	Orthopilot	Taesan Sol Puddu or Aesculap dual open wedge plate	Navigated group - better correction of mechanical axis and weightbearing line, better functional scores. No difference in tibial slope in either group. No difference in operative time between groups.	2 cases of delayed union, one varus collapse, all associated with breakage of lateral tibial cortex during medial opening
Bae 2009 [52]	Comparative study navigated v conventional CWHTO	82 (100 knees; 50 conventional, 50 navigated	Post operative	Vectorvision	Miniplate staple	Navigated group – better correction of mechanical axis and better control of tibial slope.	None mentioned
Iorio 2010 [49]	Case series navigated OWHTO	13 (14 knees; 3D HTO navigation in 6 patients)	5-35 months (mean 12.6)	Orthopilot	B Braun Position HTO plate	Good correction of mechanical axis. No change in Insall-Salvati index postoperatively. Good functional scores postoperatively. Good control of tibial slope with 3D navigation only. Mean operative time 78.9 mins	None
Akamatsu 2011 [50]	Comparative study of navigated v conventional OWHTO	48 (59 knees)	1 year	Orthopilot	Synthes Tomofix	Navigated group – less undercorrection of femorotibial angle and Tibial slope preserved better. No difference in functional scores between groups. Navigated operations took 16 mins longer	None
Gebhard 2011 [51]	Multicentre case series of navigated OWHTO	51	6 weeks	Vectorvision	Tomofix	7 patients with postoperative mechanical axis out of range. Mean length surgery 105 mins	8 intraoperative technical complications