Complications after medial opening wedge high tibial osteotomy

Abstract

Purpose: The purpose of this study was to investigate complications of the medial opening wedge high tibial osteotomy (HTO) procedure at our institution.

Methods: All cases of medial opening wedge HTO performed between 2001 and 2004 at our institution were identified. Medical records, operative reports, and radiographs were retrospectively reviewed for all patients who experienced a complication within 12 months postsurgery. All complications were identified for analysis.

Results: Forty-six patients were included in this study; 17 (36.9%) patients had a documented complication. There were 7 patients (15.2%) with loss of correction, 2 (4.3%) with intraoperative lateral cortex fractures, 2 (4.3%) with postoperative lateral cortex fractures, 2 (4.3%) with deep venous thrombosis, 2 (4.3%) with delayed unions, and 2 (4.3%) with symptomatic hardware. Patients with a loss of angular correction had a greater body mass index (BMI) than those without a loss of correction (mean BMI, 32.5 v 28.8; P = .0416). Of the 7 patients with loss of angular correction, 6 had a first-generation fixation device and 1 had a second-generation device. There was no apparent association between delayed union and graft type (allograft v autograft).

Conclusions: The medial opening wedge HTO is associated with a moderate frequency of complications. The frequency and type of complications seem to be similar to those reported for the lateral closing technique. Although there are technical advantages offered by the medial opening wedge HTO, their influence on the frequency and type of complications experienced by patients in our series was not apparent.

Level of evidence: Level IV, case series.