International Orthopaedics

, Volume 34, Issue 2, pp 217–223 | Cite as

Stability of medial opening wedge high tibial osteotomy: a failure analysis

  • E. M. Nelissen
  • E. J. van Langelaan
  • R. G. H. H. Nelissen
Original Paper

Abstract

Medial opening wedge high tibial osteotmy (HTO) is often used to treat varus gonarthrosis in young, active, highly demanding patients, although it has many pitfalls, which were evaluated in a consecutive cohort of patients. A retrospective analysis of a consecutive series of 45 patients with 49 medial opening HTO for varus gonarthrosis using a spacer plate (Puddu I, Arthrex, USA) were included. A Chi square test was used to study the effect between the wedge size and complications. Complications occurred in 22 knees (45%). There was no significant difference between groups for individual complications; however, when combined, there were significantly more complications in the >10 mm wedge group (Chi square p = 0.05). The overall complication rate in this series was 45%. The majority were related to intrinsic instability at the osteotomy site (24%) and surgical technique (20%). The evaluated spacer provided inadequate stability.

Résumé

Analyse des échecs après ostéotomie tibiale d’ouverture interne. L’ostéotomie tibiale d’ouverture interne HTO est très souvent utilisée dans le traitement des gonarthroses en varus chez le sujet jeuneet actif, cependant, il existe beaucoup de pièges. Ceux-ci ont été évalués sur une cohorte de patients consécutifs. Analyse rétrospective d’une série consécutive de 45 patients ayant bénéficié de 49 ostéotomies internes d’ouverture du tibia pour gonarthrose en varus utilisant une plaque spéciale de type Puddu (Arthrex USA). Le Chi test a été utilisé de façon à évaluer les effets secondaires dûs à l’importance de la taille du spacer et ses complications. 45% de complications (22 genoux) sont apparues. Il n’y a pas de différence significative entre les groupes concernant les complications habituelles, cependant il existe un taux significativement plus important de complications si l’ouverture osseuse est supérieure à 10 m (Chi Square p = 0,05). Globalement, le taux de complications de cette série est de 45% dont la majorité est secondaire à des problèmes d’instabilité au niveau de l’ostéotomie (24%) ou de la technique chirurgicale (20%). Cette plaque spéciale ne permet pas d’avoir une bonne stabilité de l’ostéotomie.

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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • E. M. Nelissen
    • 1
  • E. J. van Langelaan
    • 2
  • R. G. H. H. Nelissen
    • 1
  1. 1.Department of Orthopaedic SurgeryLeiden University Hospital (LUMC)LeidenThe Netherlands
  2. 2.Department of Orthopaedic SurgeryRijnland HospitalLeiderdorpThe Netherlands

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