[Complication analysis after angle-stable CW and OW high tibial osteotomy]

Area of Science:

• Orthopedic surgery
• Biomechanics
• Medical device technology

Background:

• High tibial osteotomy (HTO) is a joint-preserving surgical option for medial knee osteoarthritis.
• Complications associated with HTO can negatively impact treatment outcomes.
• Comparing different HTO techniques is essential for improving patient results.

Purpose of the Study:

• To analyze and compare complication rates between angle-stable navigated closed wedge (CW) HTO and conventional angle-stable open wedge (OW) HTO.
• To identify factors influencing complication occurrence after these procedures.
• To evaluate the suitability of each HTO technique based on patient characteristics.

Main Methods:

• Retrospective analysis of 281 HTO procedures (187 CW-HTO, 94 OWHTO).
• Inclusion of patient demographics (age, sex, BMI) and surgical parameters.
• Statistical analysis using binary logistic regression to determine influence factors.

Main Results:

• Overall complication rate was 21.4% (25.1% CW-HTO vs. 13.8% OWHTO, p=0.02).
• Minor complications were significantly higher after CW-HTO (11.2% vs. 3.2%, p=0.03), mainly due to peroneal nerve lesions and fibular pseudarthrosis.
• Age ≥52 years and BMI ≥30 kg/m² predicted mechanical complications in CW-HTO but not OWHTO.

Conclusions:

• Open wedge HTO demonstrates lower overall complication rates compared to closed wedge HTO.
• OWHTO is advantageous due to the avoidance of CW-HTO-specific complications.
• Patient selection is critical for minimizing postoperative complications, with OWHTO offering broader patient applicability.