Digital Preoperative Planning for High Tibial Osteotomy using 2D Medical Imaging

The pre-operative planning process for High Tibial Osteotomy (HTO) is vital to correct the deformity of the long bones. The most important process is needed to find the Centre Of Rotation of Angulation (CORA) and display the forecast result based on the value of the correction angles simultaneously. Presently, these practices should be done manually because current software only can define either CORA’s point or correction angle at one time. This paper proposed to use computer-aided software to make the fully digitized process of pre-operative planning for HTO to be done. For this purpose, we introduced OsteoAid software. This software enables the user to define the mechanical or anatomical axes and define the CORA’s point and the angle at one time. For testing purposes, we compared the reliability of osteotomy's correction angle between this two software (MedWeb and OsteoAid) in preoperative planning open-wedge high tibial osteotomy. This is to ensure that the new software is reliable for the correction. Thirteen digital long leg radiographs with long-standing positions from the frontal axis showing patients with both tibia deformities were examined using intra-class correlation. Those images are accessed from the picture archiving and communication system (PACS). Three medical officers (raters) who were involved in an osteotomy used the same medical image format twice with a two-week interval. Using the MedWeb software, the mean correction angle score of each rater is at excellent level: 0.989 (intra-rater1), 0.982 (intra-rater2) and 0.972 (intra-rater3). Scores of each rater for OsteoAid are also excellent: 0.949, 0.987 and 0.986 respectively. The inter-rater reliabilities of the correction angle were 0.820 and 0.979 (p<0.001) respectively for each software. The principal finding of this study was that the new software (OsteoAid) showed excellent reliabilities and good consistency in preoperative planning in finding CORA and correction angle.

@article{Awang2021,
  title     = {Digital Preoperative Planning for High Tibial Osteotomy using 2D Medical Imaging},
  journal   = {International Journal of Advanced Computer Science and Applications},
  volume    = {12},
  number    = {10},
  year      = {2021},
  publisher = {The Science and Information Organization},
  author    = {Norazimah Awang and Faudzi Ahmad and Rosnita A. Rahaman and Riza Sulaiman and Azrulhizam Shapi’i and Abdul Halim Abdul Rashid},
  doi       = {10.14569/IJACSA.2021.0121086},
  url       = {https://doi.org/10.14569/IJACSA.2021.0121086}
}