• Cristiano Hossri Ribeiro, Mauricio Sante Bettio Mod, Daniel Isch, Clemens Baier, Guenther Maderbacher, Nilson Roberto Severino, and Daniele Cristina Cataneo.
• Knee Surgery Division, Hospital Orto, Av. Nove de Julho, 1017, Vila Icaraí, São José dos Campos, SP, 12243-690, Brazil. alelorenti@yahoo.com.br.
• Arch Orthop Trauma Surg. 2020 Feb 1; 140 (2): 203-208.

IntroductionThe complications of the open-wedge osteotomy technique (slope, hypo- and hypercorrection and fractures) are related to difficulties in the control of the open-wedge angle during surgery.Materials And MethodsIn this cadaveric study, we evaluated the safety and precision of a novel system, the Realignment High Control System (RHC), in the correction of knee mechanical axis and slope. The RHC has a fixation plate coupled to a dynamic device that opens the osteotomy continuously, allowing plate fixation before osteotomy wedge opening.ResultsAll procedures were easily performed, with no fractures. The openings equaled the indicated by the navigation system for 7.5° and 10°, and for 5°, there was a statistically, although not clinically significant, difference of 0.6°. The slope shown by the RHC setting and in the navigation system was significantly different for the 10° setting only, with a mean difference of 0.563°.ConclusionsRHC facilitates the surgical technique of high tibial osteotomy, with gradual wedge opening, precise correction of the mechanical axis, and appropriate control of the tibial slope, even with larger openings.

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