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Risk Factor Analysis for Infection after Medial Open Wedge High Tibial Osteotomy
Ta-Wei Liu1, Chih-Hao Chiu2,3, Alvin Chao-Yu Chen1,2
1Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Linkou 333, Taiwan.
Background:
Medial open wedge high tibial osteotomy (MOWHTO) is a well-established treatment for osteoarthritis of the medial tibiofemoral compartment. Surgical site infection (SSI) after MOWHTO is a devastating complication that may require further surgery. In this study, we aimed to identify the risk factors for infection after MOWHTO over 1 to 4 years of follow-up.
Methods:
Fifty-nine patients who underwent MOWHTO combined with knee arthroscopic surgery were included in this prospective study. Artificial bone grafts were used in all cases. Possible risk factors, including sex, age, body mass index (BMI), underlying disease, hospitalization length, correction angle, and surgery time, were recorded. Both univariate and multivariate analysis were used.
Results:
A total of 59 patients who underwent 61 operations were included. Eleven patients (18.0%) were reported to have SSI. Univariate analysis showed that smoking and diabetes mellitus were positively associated with SSI. Multivariate analysis showed that smoking and age were positively associated with SSI. Three patients (4.9%) were reported to suffer from deep SSI, requiring surgical debridement, all of whom were male smokers.
Conclusion:
Smoking, diabetes mellitus, and old age were identified to be possible risk factors of SSI after MOWHTO. These findings are common risk factors of SSI after orthopedic surgery according to the literature. Patient selection should be performed cautiously, and postoperative prognosis for MOWHTO should be carefully explained to patients who smoke.
Insights
Smoking, diabetes, and older age increase the risk of surgical site infection (SSI) after medial open wedge high tibial osteotomy (MOWHTO). Careful patient selection and counseling are crucial for high-risk individuals undergoing MOWHTO surgery.
Area of Science:
- Orthopedic Surgery
- Infectious Disease
- Biomaterials
Background:
- Medial open wedge high tibial osteotomy (MOWHTO) effectively treats medial tibiofemoral compartment osteoarthritis.
- Surgical site infection (SSI) is a severe complication of MOWHTO, potentially necessitating revision surgery.
Purpose of the Study:
- To identify risk factors associated with surgical site infection (SSI) following medial open wedge high tibial osteotomy (MOWHTO).
- To analyze these risk factors over a 1 to 4-year follow-up period.
Main Methods:
- Prospective study including 59 patients undergoing MOWHTO with knee arthroscopy and artificial bone grafts.
- Evaluation of risk factors: sex, age, BMI, comorbidities, hospitalization, correction angle, and surgery duration.
- Univariate and multivariate statistical analyses were employed.
Main Results:
- An 18.0% SSI rate was observed in 59 patients (61 operations).
- Univariate analysis linked smoking and diabetes mellitus to SSI.
- Multivariate analysis identified smoking and older age as significant risk factors for SSI.
Conclusions:
- Smoking, diabetes mellitus, and advanced age are identified as risk factors for SSI after MOWHTO.
- These factors align with known SSI risks in orthopedic surgery.
- Emphasizes cautious patient selection and informed consent regarding smoking's impact on MOWHTO outcomes.
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