@article{KomnikFunkenZachowetal.2024, author = {Komnik, Igor and Funken, Johannes and Zachow, Stefan and Schmidt-Wiethoff, R{\"u}diger and Ellermann, Andree and Potthast, Wolfgang}, title = {Surgical planning in HTO - Alternative approaches to the Fujisawa gold-standard}, journal = {Technology and Health Care}, doi = {10.1177/09287329241299568}, url = {http://nbn-resolving.de/urn:nbn:de:0297-zib-98227}, year = {2024}, abstract = {BACKGROUND: Presurgical planning of the correction angle plays a decisive role in a high tibial osteotomy, affecting the loading situation in the knee affected by osteoarthritis. The planning approach by Fujisawa et al. aims to adjust the weight-bearing line to achieve an optimal knee joint load distribution. While this method is accessible, it may not fully consider the complexity of individual dynamic knee-loading profiles. This review aims to disclose existing alternative HTO planning methods that do not follow Fujisawa's standard. METHODS: PubMed, Web of Science and CENTRAL databases were screened, focusing on HTO research in combination with alternative planning approaches. RESULTS: Eight out of 828 studies were included, with seven simulation studies based on finite element analysis and multi-body dynamics. The planning approaches incorporated gradual degrees of realignment parameters (weight-bearing line shift, medial proximal tibial angle, hip- knee-ankle, knee joint line orientation), simulating their effect on knee kinematics, contact force/stress, Von Mises and shear stress. Two studies proposed implementing individual correction magnitudes derived from preoperatively predicted knee adduction moments. CONCLUSION: Most planning methods depend on static alignment assessments, neglecting an adequate loading-depending profile. They are confined to their conceptual phases, making the associated planning methods unviable for current clinical use.}, language = {en} }