Comparison of Clinical and Radiological Outcomes between Calibratable Patient-Specific Instrumentation and Conventional Operation for Medial Open-Wedge High Tibial Osteotomy: A Randomized Controlled Trial

Figure 5

Surgical technique of PSI. (a, b) Preoperative imaging. The Insall–Salvati index is indicated by the green lines: ratio of the length from the inferior pole of the patella to the superior border of the tibial tuberosity and the longest diagonal length of the patella. The PTSA is indicated by the yellow lines. (c) Installation and fixation of the proximal osteotomy guide. (d) X-ray fluoroscopy to confirm the position of the guide. (e) Biplanar osteotomy according to the orientation of the osteotomy guide and Kirschner wires. (f) Calibration of the open wedge with the aid of calibratable rod. (g) Intraoperative radiography to assist in confirming the alignment of lower limb. (h) Installation of the plate fixator under the guidance of the positioning wedge block. (i, j) Postoperative imaging. (PSI: patient-specific instrumentation. PTSA: posterior tibial slope angle.).

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