Complications Associated With Medial Opening-Wedge High Tibial Osteotomy Using a Locking Plate: A Multicenter Study

Area of Science:

• Orthopedic surgery
• Biomechanical engineering
• Medical device technology

Background:

• Medial opening-wedge high tibial osteotomy (HTO) is a common procedure for knee osteoarthritis.
• Locking plates are frequently used for fixation in HTO.
• Understanding complication rates and their impact is crucial for patient outcomes.

Purpose of the Study:

• To investigate complications following medial opening-wedge high tibial osteotomy (HTO) using a locking plate.
• To compare postoperative outcomes between patients with and without complications.

Main Methods:

• Retrospective review of 209 patients undergoing medial opening-wedge HTO (2010-2015).
• Complications assessed up to 2 years postoperatively, categorized as major or minor.
• Clinical outcomes evaluated using the Western Ontario McMaster University Osteoarthritis Index (WOMI).

Main Results:

• Overall complication rate was 29.7%, with undisplaced lateral hinge fracture being the most common (12.0%).
• Major complications occurred in 8.6% of patients.
• The major complication group demonstrated significantly worse WOMI scores at 1 and 2 years postoperatively.

Conclusions:

• The overall complication rate for medial opening-wedge HTO with a locking plate is substantial.
• Minor complications are more frequent, but major complications significantly impact long-term clinical outcomes.
• This study underscores the importance of monitoring for and managing complications to improve patient results after HTO.