Complications in high tibial (medial opening wedge) osteotomy.
BACKGROUND
The high tibial (medial opening wedge) osteotomy (HTO) is a standard procedure in the treatment of varus gonarthrosis. This is potentially associated with various complications. The aim of this study was an analysis of complications and potential technical mistakes.


METHODS
A total of 85 patients (49 male and 36 female) suffering from varus gonarthrosis underwent a medial opening wedge HTO. The osteotomy was fixed in 55 patients by a spacer plate (Puddu plate; group A). In group B (n=30), the osteotomies were fixed by C-plate.


RESULTS
The rate of complications was 43.6% in group A and 16.7% in group B (p<0.05). Infraction of the lateral tibial head is a possible intraoperative complication. This was seen in 11.7%. An additional osteosynthesis was required in group A. In contrast, the C-plate can solve this problem without additional measures. General complications of the HTO were seen: infection (4.7%), hematoma (4.7%), and thrombosis (2.3%). In every case of a severe deep infection, the osteotomy space was filled with synthetic bone graft. These grafts were used only in group A. Failure of the implants is a potential cause of loss of correction. This complication was seen nine times in group A but never in group B.


CONCLUSIONS
A diligent surgical technique and a convenient implant are obligatory in (medial opening wedge) HTO.
Spahn
Gunter
G
Clinic of Arthroscopy and Joint Surgery Eisenach, Sophienstrasse 16, 99817 Eisenach, Germany. Spahn.ESA@t-online.de
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009984:Orthopedic Fixation Devices; D020370:Osteoarthritis, Knee / Q000601:surgery*; D010027:Osteotomy / Q000009:adverse effects* / Q000295:instrumentation; D011183:Postoperative Complications; D013977:Tibia / Q000601:surgery*