title: Complications associated with opening wedge high tibial osteotomy--A review of the literature and of 15 years of experience.
abstract: BACKGROUND
  Complication rates following opening wedge high tibial osteotomy (OWHTO) is an issue that has not been comprehensively addressed in current literature.
  
  
  METHODS
  We performed a retrospective study of local patients who underwent OWHTO for isolated medial compartment knee osteoarthritis from 1997 to 2013. We analysed survivorship and complication rates and compared this to a literature review of previously reported data.
  
  
  RESULTS
  One hundred and fifteen patients met the inclusion criteria. Mean follow-up=8.4 years. Mean age=47 (range 32 to 62). Mean Body Mass Index (BMI)=29.1 (range 20.3 to 40.2). Devices used consisted of Tomofix (72%), Puddu plate (21%) and Orthofix (seven percent) (no significant differences in age/sex/BMI). Wedge defects were filled with autologous graft (30%), Chronos (35%) or left empty (35%). Five years survival rate (without requiring conversion to arthroplasty)=80%. Overall complication rate=31%. Twenty five percent of patients suffered 36 complications including minor wound infections (9.6%), major wound infections (3.5%), metalwork irritation necessitating plate removal (seven percent), non-union requiring revision (4.3%), vascular injury (1.7%), compartment syndrome (0.9%), and other minor complications (four percent). No thromboembolic complications were observed.
  
  
  CONCLUSIONS
  No significant differences existed in complication rates following OWHTO relative to BMI, implant type, type of bone graft used or patient age at surgery. When the complications from OWHTO were analysed closely they appear higher than previously reported in the literature; however serious complications appear rare. LEVEL OF EVIDENCE 3: Retrospective cohort study.
authors.affiliation: Royal Devon and Exeter Hospital, Barrack Road, Exeter, Devon EX25DW, UK; Torbay Hospital, Newton Road, Torquay, Devon TQ27AA, UK. Electronic address: timwoodacre@yahoo.co.uk.
authors.forename: T
authors.initials: T
authors.lastname: Woodacre
authors.affiliation: Torbay Hospital, Newton Road, Torquay, Devon TQ27AA, UK. Electronic address: m.k.ricketts@doctors.org.uk.
authors.forename: M
authors.initials: M
authors.lastname: Ricketts
authors.affiliation: Royal Devon and Exeter Hospital, Barrack Road, Exeter, Devon EX25DW, UK. Electronic address: johnathanevans1@nhs.net.
authors.forename: J T
authors.initials: JT
authors.lastname: Evans
authors.affiliation: Royal Devon and Exeter Hospital, Barrack Road, Exeter, Devon EX25DW, UK. Electronic address: gpav@doctors.org.uk.
authors.forename: G
authors.initials: G
authors.lastname: Pavlou
authors.affiliation: Royal Devon and Exeter Hospital, Barrack Road, Exeter, Devon EX25DW, UK. Electronic address: peter.schranz@nhs.net.
authors.forename: P
authors.initials: P
authors.lastname: Schranz
authors.affiliation: Torbay Hospital, Newton Road, Torquay, Devon TQ27AA, UK. Electronic address: michael.hockings@nhs.net.
authors.forename: M
authors.initials: M
authors.lastname: Hockings
authors.affiliation: Royal Devon and Exeter Hospital, Barrack Road, Exeter, Devon EX25DW, UK. Electronic address: andrewtoms@nhs.net.
authors.forename: A
authors.initials: A
authors.lastname: Toms
mesh_terms: D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D020370:Osteoarthritis, Knee / Q000601:surgery*; D010027:Osteotomy / Q000009:adverse effects*; D011183:Postoperative Complications; D012086:Reoperation; D012189:Retrospective Studies; D013977:Tibia / Q000601:surgery*
keywords: Complications; Knee; Osteotomy; Surgery