Managing a complex tibial realignment with accuracy and control

This case involved a proximal tibial valgus deformity, previously operated and stabilized with a plate. The objective was to restore alignment while preserving joint congruency — all within a technically demanding surgical context.

To support this, a fully customized solution was developed using patient-specific 3D-CUT OSTEO cutting and alignment guides. 

Here, the plate already present in the patient was used to enhance the stability of the guide on the bone.

Here’s how the case was approached and executed:

Case of tibial corrective osteotomy aiming to correct the lateral plateau; performed using custom cutting and alignment guides.

The patient presented with a valgus deformity of the proximal tibia, previously operated and stabilized with a plate. The objective was clear: correct the mechanical axis while preserving joint congruency — in a technically demanding context.

Correction objectives:

A 3D correction plan was validated based on bilateral measurements and mirrored modeling of the contralateral limb. The strategy combined opening and rotation of the tibial plateau to restore satisfactory symmetry.

Key technical points:

• A patient-specific 3D-CUT OSTEO guide was developed with several adjustments:

 – Addition of a proximal K-wire to secure fixation

 – Extended anterior contact for greater stability

 – Reduced posterolateral contact area to allow removal of the existing plate

• Saw blade thickness adjusted to 1.2 mm to match the planned cuts

• Cutting and drilling depths engraved on the guide for optimal intraoperative control

• An anterior alignment guide, fixed with 4 K-wires, enabled controlled opening of the fragment while ensuring proper alignment

Outcome: A correction fully aligned with the preoperative plan, respecting both anatomical structures and the constraints of a complex surgical site.

A complex planification — carried out flawlessly!

#3dcut #cuttingguide #preopplanning