High tibial osteotomy (HTO) is an established operative procedure for correction of knee deformity in patients with unicompartmental osteoarthritis. With this procedure the affected area is decompressed and the leg axis is restored. The major benefit is the bone preservation and the prevention of total knee replacement. Τhe procedure is performed without objective measurements and the surgeon is following his personal judgment. Now this procedure can be performed with the assistance of robot – computer where the surgeon’s capability collaborates with computer’s ability to complete the procedure for optimal result.

 High Tibial Osteotomy with
Computer Navigation

The most common example of passive robotic systems is the Computer Navigation, where information such as resection plane, orientation or limb alignment is displayed on a monitor. The aim of this development was the optimal limb alignment and the soft tissue management without the use of expensive preoperative examinations like CT or MRI scan.

“Tibial osteotomy is a joint preservation technique”

Who are candidates


A patient who can be considered for high tibial osteotomy should be up to 65 years of age with unicompartmental arthrosis. Pain should be localized, load-dependent  which often occurs during sporting activity but which ideally disappears again in rest periods. The deformity should be < 10°, with stable ligaments, and the range of movement safficient.

How it works


The surgeon fixes sensors in the part of the patient being operated on and then moves the patient’s limb in specific natural movements so that the camera receives the data and uses it to form a 3D model on the screen. The data, the 3D morphology and the size of the bone, represented on the monitor, allow the surgeon to perform the surgery with greater accuracy, as the system will be able to judge in real time when the joint is properly aligned. This can reduce both the mechanical and the shear stress on the bearing surfaces leading to longer longevity of the joint and better clinical result.

With software’s continuous development surgery with computer navigation can be performed quickly, securely and in comparable time with conventional technique.

Stages of surgical procedures

  • Free image computer navigation is used
  • The transmitters are placed on the operated leg
  • Leg kinematics and anatomical landmarks are registered
  • A 3D model is represented
  • Correction osteotomy is performed with high precision
  • A plate is applied to allow bone healing in the new position

“In our surgical procedures we use fast track protocols”



During the surgical procedure and condition treatment as well, technology is once again by our side providing many benefits against conventional surgical techique.

  • Personalized treatment according to patient’s anatomy. All patients are different so are their knees!
  • We use the most advantaged, reliable, most used and twice awarded system Οrthopaedic Navigation System (Orthopilot).
  • Accurate and safer operation
  • Objective and optimal knee alignment.
  • With navigation system there is no need of expensive (MRI) or radiation exposure exams (CT)
  • Proven reability and effectiveness from more than 300 publications.
  • Routine use in more than 350.000 cases worldwide.
  • Improvement in clinical results.
  • Early rehabilitation and shorter hospital stay.
  • Maximum possible longevity of the knee joint.
  • Same cost as conventional procedure

For more information request an appointment.

We are always contactable to inform you about this technique and it’s benefits

Robotic Surgery


What this offers is another navigation system to plan the operation. The thing to keep in mind is that the robots involved in surgery are not completely autonomous but they’re controlled by the doctor. Thus, doctors can combine their knowledge and judgment with the precision and control of a robot.

By using CT scan information, the system can create 3-D images of the joint and enables the surgeon to plan and customize the surgical procedure with precision for your unique joint.

As the surgeon manipulates the robotic arm he is receiving a real time feedback or guidance to plan precisely the alignment of the knee



Optimal deformity correction with high precision

  • Wu ZP et al. Comparison of navigated and conventional high tibial osteotomy for the treatment of osteoarthritic knees with varus deformity: A meta-analysis. Int J Surg. 2018 Jul;55:211-219
  •  Kim HJ. Imageless Navigation Versus Conventional Open Wedge High Tibial Osteotomy: A Meta-Analysis of Comparative Studies. Knee Surg Relat Res. 2016 Mar;28(1):16-26
  • Akamatsu Y et al. Comparative Study of Opening-Wedge High Tibial Osteotomy With and Without a Combined Computed Tomography-Based and Image-Free Navigation System. Arthroscopy. 2016 Oct;32(10):2072-2081
  •  Saragaglia D. Role of computer-assisted surgery in osteotomies around the knee. Knee Surg Sports Traumatol Arthrosc. 2016 Nov;24(11):3387-3395
  • Yan J et al. Outcome reporting following navigated high tibial osteotomy of the knee: a systematic review. Knee Surg Sports Traumatol Arthrosc. 2016 Nov;24(11):3529-3555

Improvement in patient’s satisfaction

  • Ribeiro CH. Opening wedge high tibial osteotomy: navigation system compared to the conventional technique in a controlled clinical study. Int Orthop. 2014 Aug;38(8):1627-31.
  • Saragaglia D1, Chedal-Bornu B. Computer-assisted osteotomy for valgus knees: medium-term results of 29 cases. Orthop Traumatol Surg Res. 2014 Sep;100(5):527-30

50% reduction in radiation exposure

  •  Na YG et al. The use of navigation in medial opening wedge high tibial osteotomy can improve tibial slope maintenance and reduce radiation exposure. Int Orthop. 2016 Mar;40(3):499-507