title: Stability of medial opening wedge high tibial osteotomy: a failure analysis.
abstract: Medial opening wedge high tibial osteotmy (HTO) is often used to treat varus gonarthrosis in young, active, highly demanding patients, although it has many pitfalls, which were evaluated in a consecutive cohort of patients. A retrospective analysis of a consecutive series of 45 patients with 49 medial opening HTO for varus gonarthrosis using a spacer plate (Puddu I, Arthrex, USA) were included. A Chi square test was used to study the effect between the wedge size and complications. Complications occurred in 22 knees (45%). There was no significant difference between groups for individual complications; however, when combined, there were significantly more complications in the >10 mm wedge group (Chi square p = 0.05). The overall complication rate in this series was 45%. The majority were related to intrinsic instability at the osteotomy site (24%) and surgical technique (20%). The evaluated spacer provided inadequate stability.
authors.affiliation: Department of Orthopaedic Surgery, Leiden University Hospital (LUMC), kamer J11-70, Postbus 9600, 2300 RC, Leiden, The Netherlands. e_nelissen@yahoo.com
authors.forename: E M
authors.initials: EM
authors.lastname: Nelissen
authors.forename: E J
authors.initials: EJ
authors.lastname: van Langelaan
authors.forename: R G H H
authors.initials: RG
authors.lastname: Nelissen
mesh_terms: D000328:Adult; D000368:Aged; D001178:Arthroplasty / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D001860:Bone Plates; D015331:Cohort Studies; D005260:Female; D006801:Humans; D016916:Joint Deformities, Acquired / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D007593:Joint Instability / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D007719:Knee Joint / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D020370:Osteoarthritis, Knee / Q000150:complications / Q000503:physiopathology / Q000601:surgery; D010027:Osteotomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology; D011475:Prosthesis Failure; D012189:Retrospective Studies; D013977:Tibia / Q000601:surgery*