Evaluation of the Accuracy of a Novel Wedge Osteotomy Guide

Introduction: Wedge osteotomies are described for various orthopaedic procedures. Corrective osteotomies are technically difficult, and accurate osteotomies are important for good outcomes. Our objective was to evaluate a novel coplanar wedge osteotomy guide. We hypothesized that use of this device would produce consistent wedge osteotomies with accuracy similar to traditional methods.

Materials and Methods: A 30-degree cranial closing wedge osteotomy was created using canine tibia models with either a standard template or the aid of a 30-degree wedge osteotomy guide by two diplomate surgeons. One surgeon was experienced with both procedures, and one surgeon had no previous experience with the wedge guides. The wedges were evaluated for wedge angle and coplanarity using digital measuring modalities. Two-way ANOVA testing was used to test outcomes between each surgeon, each method, and each surgeon performing each method. The deviation of WA from measured guide/template angles (accuracy) was compared with Wilcoxon’s test, with significance set at p = 0.05.

Results: The mean (SD) wedge angles of the traditional and cut-guide groups were 28.16 (1.33) and 28.4 (1.46) degrees, respectively. Individual and cross-surgeon analysis of outcomes found no statistically significant differences when comparing wedge angle or coplanarity. Technique G was significantly more accurate than technique T (p = 0.01).

Discussion/Conclusion: Use of a novel surgical wedge guide was successful in consistently producing accurate cranial closing wedge osteotomies, and we accepted our hypothesis. These cut guides should be considered when performing wedge osteotomy procedures because they are accurate, intuitive, and time and cost-effective.

Acknowledgment: Mr. Rich Evans provided statistical analysis for this project.