Use of an ACL Tibial Drill Guide to Reduce Radiation Exposure During High Tibial Osteotomy: A Comparative Analysis
Öz
Background: Medial open-wedge high tibial osteotomy (HTO) is an established treatment for medial compartment osteoarthritis in patients with varus alignment. Accurate K-wire placement is essential for a safe and reproducible osteotomy, yet it often requires repeated fluoroscopic checks, increasing radiation exposure. To evaluate whether an anterior cruciate ligament (ACL) tibial drill guide improves the accuracy of K-wire placement and reduces radiation exposure and surgical time compared with the freehand technique.
Methods: This retrospective study included 40 patients who underwent medial open-wedge HTO. Patients were divided into a Freehand Group (n=20) and a Guided Group (n=20), in which an ACL tibial drill guide was used for K-wire placement. Primary outcomes were the number of fluoroscopic images, radiation dose, surgical time, and K-wire repositioning rate.
Results: The Guided Group required significantly fewer fluoroscopic images (11.7 ± 2.8 vs. 27.2 ± 5.2; p<0.001) and had a substantially lower radiation dose (9.36 ± 2.24 vs. 23.76 ± 4.16 mGy; p<0.001). Surgical time was shorter (60.9 ± 8.7 vs. 78.2 ± 12.4 minutes; p<0.001), and K-wire repositioning was less frequent (8.8% vs. 38.8%; p=0.001).
Conclusion: The ACL tibial drill guide may serve as a useful adjunct in medial open-wedge HTO, enabling more precise K-wire placement while reducing radiation exposure and operative time. Further prospective studies are needed to validate these findings.
Anahtar Kelimeler
Osteotomy, Knee Joint, Orthopedic Procedures, Radiation Exposure, Surgical Instruments
Destekleyen Kurum
This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. No funding body had any role in the study design; collection, analysis, or interpretation of the data; preparation of the manuscript; or decision to submit the manuscript for publication.
Etik Beyan
Ethical approval for this retrospective study was obtained from the Kutahya Health Science University Clinical Research Ethics Committee (Approval No. 2020/090-17; date: 5 September 2020). The study was conducted in accordance with the principles of the Declaration of Helsinki and relevant institutional and national ethical standards. Written informed consent was obtained from all participants before inclusion in the study.
Teşekkür
None. The authors have no individuals or organizations to acknowledge.
Kaynakça
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