Complications Following Medial Opening Wedge Osteotomy of the Knee: Retrospective Study

Abstract

Objective: To retrospectively survey the most frequent complications from medial opening wedge high-tibial osteotomy. This procedure is becoming increasingly important in treating knee arthrosis, as one of the options for young and active patients. Despite satisfactory results and its benefits, it is not a complication-free procedure. Methods: All cases of medial opening wedge high-tibial osteotomy above the tibial tubercle with fixation using a Puddu plate that were performed at the Celso Pierro Hospital and Maternity Hospital, Pontifical Catholic University of Campinas (PUC-Campinas) and the Wilson Mello Institute, Campinas, between October 1, 1987, and October 30, 2008, were evaluated retrospectively. Patients with less than 12 months of follow-up or incomplete medical files, and those who underwent bilateral osteotomy, were excluded. Results: Out of the 67 cases evaluated, 55 were males and 12 were females, with a mean age of 49.5 years. The mean wedge size was 10.15 mm and the most common complications were moderate to severe pain (13.04%), stiffness (6.52%), material breakage (4.4%), intraoperative fracture of the lateral cortical bone (4.4%) and infection (4.4%). It was observed that patients with delayed consolidation of the osteotomy had a greater chance of presenting complications (p < 0.05). Conclusion: Complications from medial wedge osteotomy are more frequent when associated with delayed consolidation.

Assessment of proprioceptive exercises in the treatment of rotator cuff disorders in nursing professionals: a randomized controlled clinical trial

“…Pain levels greater than three and less than or equal to seven were considered moderate, and pain levels greater than seven, severe 13 . After pain classification, the subjects were divided into six subgroups: a) mild pain and no deficit; b) mild pain and deficit; c) moderate pain and no deficit; d) moderate pain and deficit; e) severe pain and no deficit; f) severe pain and deficit.…”

The effect of plate design, bridging span, and fracture healing on the performance of high tibial osteotomy plates

“…11 Infection is generally the most common complication (approximately 10%), 11 while reported rates of nonunion and delayed union range from 4.3% to 8.2%, 11-13 and rates of implant breakage range from 4.4% to 10%. 14,15 Patients with delayed consolidation of the osteotomy have been reported to have a significantly (p < 0.05) greater likelihood of complications. 14 Therefore, due to the importance of preventing nonunions and delayed unions from occurring, promotion of fracture healing should be a priority in HTO surgery.…”

“…14,15 Patients with delayed consolidation of the osteotomy have been reported to have a significantly (p < 0.05) greater likelihood of complications. 14 Therefore, due to the importance of preventing nonunions and delayed unions from occurring, promotion of fracture healing should be a priority in HTO surgery. 16…”

Retorno ao esporte após osteotomia tibial alta com método de cunha de abertura

“…The disadvantages of the opening wedge technique include the creation of a bone defect (which, depending on its size, may need a bone graft), risk of pseudarthrosis, potential loss of correction due to synthetic collapse, and a longer period of time in which load is not allowed; moreover, this procedure requires greater attention to the tibial slope. 3 4 6 7 8…”

“…Since then, there have been countless advances in the technique, fixation, and selection of patients, leading to reduced complications and better outcomes. 3 4 6 7 8…”