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High tibial dome osteotomy is a well accepted but technically demanding surgical procedure. Common complications include postoperative malalignment of either under- or over-correction, pin penetration of the tibial plateau, and damage to the tibial dorsal neurovascular structures. In order to address all these problems, we developed a CT-free intraoperative planning and navigation system based on SurgiGATE system (Praxim-Medivision, La Tronche, France). Following acquisition of fluoroscopic images and registration of anatomic landmarks, a patient specific coordinate system is established. The deformity is measured intraoperatively and the surgical procedure is planned interactively. The osteotomy and deformity correction are performed under navigational guidance. The system holds the promise to improve the accuracy, reliability, and safety of this surgical procedure.

A CT-Free Intraoperative Planning and Navigation System for High Tibial Dome Osteotomy