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. 2016 Dec 1;28(4):289-296.
doi: 10.5792/ksrr.16.028.

Complications and Short-Term Outcomes of Medial Opening Wedge High Tibial Osteotomy Using a Locking Plate for Medial Osteoarthritis of the Knee

Seung-Suk Seo  1 , Ok-Gul Kim  1 , Jin-Hyeok Seo  1 , Do-Hoon Kim  1 , Youn-Gu Kim  1 , In-Seung Lee  1
Affiliations

Complications and Short-Term Outcomes of Medial Opening Wedge High Tibial Osteotomy Using a Locking Plate for Medial Osteoarthritis of the Knee

Seung-Suk Seo et al. Knee Surg Relat Res. .

Abstract

Purpose: The purpose of this study was to investigate complications and radiologic and clinical outcomes of medial opening wedge high tibial osteotomy (MOWHTO) using a locking plate.

Materials and methods: This study reviewed 167 patients who were treated with MOWHTO using a locking plate from May 2012 to June 2014. Patients without complications were classified into group 1 and those with complications into group 2. Medical records, operative notes, and radiographs were retrospectively reviewed to identify complications. Clinically, Oxford Knee score and Knee Injury and Osteoarthritis Outcome score (KOOS) were evaluated.

Results: Overall, complications were observed in 49 patients (29.3%). Minor complications included lateral cortex fracture (15.6%), neuropathy (3.6%), correction loss (2.4%), hematoma (2.4%), delayed union (2.4%), delayed wound healing (2.4%), postoperative stiffness (1.2%), hardware irritation (1.2%), tendinitis (1.2%), and hardware failure without associated symptoms (0.6%). Major complications included hardware failure with associated symptoms (0.6%), deep infection (0.6%), and nonunion (0.6%). At the first-year follow-up, there were no significant differences in radiologic measurements between groups 1 and 2. There were no significant differences in knee scores except for the KOOS pain score.

Conclusions: Our data showed that almost all complications of the treatment were minor and the patients recovered without any problems. Most complications did not have a significant impact on radiologic and clinical outcomes.

Keywords: Complication; Knee; Open wedge; Osteoarthritis; Osteotomy; Plate.

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Figures

Fig. 1
Fig. 1
Preoperative and postoperative 1 year radiographs. (A) Measurement of the mechanical tibiofemoral angle. (B) Measurement of the medial proximal tibia angle. (C) Measurement of the tibial posterior angle.
Fig. 2
Fig. 2
There were no significant differences in radiologic measurements between group 1 and group 2 at preoperative and postoperative 1 year. mTFA: mechanical tibiofemoral angle, MPTA: medial proximal tibial angle.
Fig. 3
Fig. 3
There were no significant differences in preoperative clinical outcome scores between group 1 and group 2. OKS: Oxford Knee score, KOOS: Knee Injury and Osteoarthritis Outcome score, ADL: activities of daily living, SR: sports and recreation, QOL: quality of life.
Fig. 4
Fig. 4
Despite the KOOS (pain) showed significant difference between group 1 and group 2, the clinical outcome scores were similar in general between the two groups. OKS: Oxford Knee score, KOOS: Knee Injury and Osteoarthritis Outcome score, ADL: activities of daily living, SR: sports and recreation, QOL: quality of life. a)Independent-samples t-test, p<0.05.
Fig. 5
Fig. 5
The complication rates in our study are lower than those in studies using the Puddu plate but higher than those in studies using the TomoFix plate.
Fig. 6
Fig. 6
Postoperative radiograph (A) and intraoperative photograph (B) in revision surgery showing locking plate failure at the osteotomy level.
See this image and copyright information in PMC

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