More accurate correction can be obtained using a three-dimensional printed model in open-wedge high tibial osteotomy.

PURPOSE: The purpose of this study was to compare the accuracy of the preoperative planning method using a three-dimensional (3D) printed model with that of a method using picture archiving and communication system (PACS) images in high tibial osteotomy (HTO).

METHODS: Patients who underwent HTO using a 3D printed model (20 patients) and a method based on PACS images (20 patients) from 2012 to 2016 were compared. After obtaining the correction angle, in the 3D printed method, the wedge-shaped 3D printed model was designed. The PACS method used preoperative radiographs. The accuracy of HTO for each method was compared using radiographs obtained at the first postoperative year. The preoperative and postoperative posterior tibial slope angles were also compared.

RESULTS: The weight-bearing line was corrected 21.2 ± 11.8% from preoperatively to 61.6 ± 3.3% postoperatively in the 3D group and from 19.4 ± 12.3% to 61.3 ± 8.1% in the PACS group. The mean absolute difference with the target point was lower in the 3D group (2.3 ± 2.5) than in the PACS group (6.2 ± 5.1; p = 0.005). The number of patients in an acceptable range was higher in the 3D group than in the PACS group. The posterior tibial slope angle was not significantly different in the 3D group (8.6°-8.9°), but was significantly different in the PACS group (9.9°-10.5°, p = 0.042).

CONCLUSIONS: In open-wedge HTO, a more accurate correction for successful results could be obtained using the 3D printed model.

LEVEL OF EVIDENCE: IV.