ReviewAnnals of joint2026
High tibial osteotomy with virtual planning and patient specific instrumentation: a narrative review.
Review in Annals of joint, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background and Objective: High tibial osteotomy (HTO), particularly through a medial opening-wedge technique [medial opening-wedge high tibial osteotomy (MOWHTO)], is a well-established surgical intervention for correcting varus malalignment and unloading the medial compartment in younger patients with early osteoarthritis or secondary ligamentous or chondral deficiency. However, conventional methods pose high technical demands for accurate alignment, often requiring repeat intraoperative fluoroscopy. Patient-specific instrumentation (PSI), developed through three-dimensional (3D) imaging and printing technologies, offers a promising solution by enabling precise preoperative planning and intraoperative execution via customized cutting guides. This narrative review aims to explore the inception and current data surrounding PSI in HTO, specifically in regards to radiation, cost effectiveness, hinge fractures, surgical accuracy, and multiplanar osteotomies. Methods: A comprehensive literature review was conducted using PubMed, incorporating studies related to "high tibial osteotomy", "virtual planning", "patient-specific instrumentation", and "3D planning" published up to March 1st, 2025. Relevant English-language studies were included to summarize the use and outcomes associated with PSI in HTO. Key Content and Findings: The literature consistently demonstrates that PSI significantly enhances the precision and reproducibility of HTO. PSI is associated with a marked reduction in intraoperative fluoroscopy use and operative time, supporting its role in improving surgical efficiency and radiation safety. The costs of PSI Conclusions: PSI represents a significant advancement in the execution of high tibial osteotomies, offering increased surgical accuracy, reduced radiation exposure, and enhanced procedural efficiency. It holds particular value in complex or multiplanar deformities where traditional techniques are limited. Although cost and hinge fracture data remain areas for further investigation, the growing body of evidence supports PSI's clinical utility and reproducibility. As 3D planning technologies and guided manufacturing become more accessible, PSI is well-positioned to become a standard adjunct in knee realignment procedures.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.