Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 Feb;34(2):217-23.
doi: 10.1007/s00264-009-0723-3. Epub 2009 Feb 3.

Stability of medial opening wedge high tibial osteotomy: a failure analysis

E M Nelissen  1 , E J van Langelaan, R G H H Nelissen
Affiliations

Stability of medial opening wedge high tibial osteotomy: a failure analysis

E M Nelissen et al. Int Orthop. 2010 Feb.

Abstract
in English, French

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.

Analyse des échecs après ostéotomie tibiale d’ouverture interne. L’ostéotomie tibiale d’ouverture interne HTO est très souvent utilisée dans le traitement des gonarthroses en varus chez le sujet jeuneet actif, cependant, il existe beaucoup de pièges. Ceux-ci ont été évalués sur une cohorte de patients consécutifs. Analyse rétrospective d’une série consécutive de 45 patients ayant bénéficié de 49 ostéotomies internes d’ouverture du tibia pour gonarthrose en varus utilisant une plaque spéciale de type Puddu (Arthrex USA). Le Chi test a été utilisé de façon à évaluer les effets secondaires dûs à l’importance de la taille du spacer et ses complications. 45% de complications (22 genoux) sont apparues. Il n’y a pas de différence significative entre les groupes concernant les complications habituelles, cependant il existe un taux significativement plus important de complications si l’ouverture osseuse est supérieure à 10 m (Chi Square p = 0,05). Globalement, le taux de complications de cette série est de 45% dont la majorité est secondaire à des problèmes d’instabilité au niveau de l’ostéotomie (24%) ou de la technique chirurgicale (20%). Cette plaque spéciale ne permet pas d’avoir une bonne stabilité de l’ostéotomie.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Complications. a Broken screws. b Lateral cortical fracture. c Infraction fracture of the lateral tibia plateau. d Fracture of the Puddu I osteotomy plate
See this image and copyright information in PMC

References

    1. Ahlback S. Osteoarthrosis of the knee. A radiographic investigation. Acta Radiol Diagn (Stockh) Suppl. 1968;277:7–72. - PubMed
    1. Brouwer RW, Jakma TSC, Bierma-Zeinstra SMA, Verhagen AP, Verhaar JAN (2005) Osteotomy for treating knee osteoarthritis. Cochrane Database Syst Rev 1:CD004019 - PubMed
    1. Brouwer RW (2006) Unicompartmental osteoarthritis of the knee: diagnosis and treatment of malalignment. Doctoral Thesis, Erasmus University, Rotterdam, 17 May 2006
    1. Catani F, Marcacci M, Benedetti MG, Leardini A, Battistini A, Iacono F, Giannini S. The influence of clinical and biomechanical factors on the results of valgus high tibial osteotomy. Chir Organi Mov. 1998;83(3):249–262. - PubMed
    1. Coventry MB. Osteotomy of the upper portion of the tibia for degenerative arthritis of the knee. A preliminary report. J Bone Joint Surg Am. 1965;47:984–990. - PubMed

MeSH terms