Skip to main content
SpringerLink
Log in

Delayed- and non-union following opening wedge high tibial osteotomy: surgeons’ results from 182 completed cases

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Opening wedge high tibial osteotomy (OWHTO) is a recently described procedure for medial compartment arthritis of the knee in the active, younger population. Despite having a number of advantages over the traditional closing wedge high tibial osteotomy (CWHTO) a potential complication of OWHTO is a high rate of delayed- and non-union. This study reports the occurrence of delayed- and non-union following OWHTO for medial compartment arthritis of the knee. Questionnaires were sent to all current members of the Australian Knee Society (n=45), a special interest group of the Australian Orthopaedic Group. Surgeons were asked primarily to indicate how many OWHTOs they had performed, and how many of these had progressed to union, delayed-union and non-union. All 45 questionnaires were returned, with 21 surgeons (47%) performing OWHTOs. A total of 188 OWHTO cases were reported, of which 182 were complete. Of these complete cases 167 (91.8%) were classed as united, 12 (6.6%) delay-united and 3 (1.6%) non-united. The results of this study demonstrate that the rate of delayed- and non-union following OWHTO for medial compartment arthritis of the knee is relatively low and comparable to that reported for traditional CWHTO.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2a,b

Similar content being viewed by others

Explore related subjects

Discover the latest articles, news and stories from top researchers in related subjects.

References

  1. Aydogdu S, Cullu E, Arac N, Varolgunes N, Sur H (2000) Prolonged peroneal nerve dysfunction after high tibial osteotomy: pre- and postoperative electrophysiological study. Knee Surg Sports Traumatol Arthrosc 8:305–308

    Article  CAS  PubMed  Google Scholar 

  2. Cameron HU, Welsh RP, Jung Y-B, Noftall F (1993) Repair of nonunion of tibial osteotomy. Clin Orthop 287:167–169

    PubMed  Google Scholar 

  3. Dowdy PA, Cole BJ, Harner CD (1998) Knee arthritis in active individuals: matching treatment to the diagnosis. Physician Sportsmed 26:43–54

    Google Scholar 

  4. Fowler PJ (2001) The role of osteotomy in the post-meniscectomy knee: an open or closed case. Presented at the American Academy of Orthopaedic Surgeons 68th Annual Meeting, San Francisco, CA

  5. Fowler PJ, Tan JL, Brown GA (2000) Medial opening wedge high tibial osteotomy: how do I do it? Oper Tech Sports Med 8:32–38

    Google Scholar 

  6. Hart JAL, Sekel R (2002) Osteotomy of the knee: is there a seat at the table? J Arthroplasty 4 [Suppl 1]:45–49

  7. Hernigou P, Ma W (2001) Open wedge tibial osteotomy with acrylic bone cement as bone substitute. Knee 8:103–110

    Article  CAS  PubMed  Google Scholar 

  8. Karabatsos B, Mahomed NN, Maistrelli GL (2002) Functional outcome of total knee arthroplasty after high tibial osteotomy. Can J Surg 45:116–119

    PubMed  Google Scholar 

  9. Kharrazi D, Chandler RW, Spitzer AI (2000) High tibial osteotomy for the treatment of unicompartmental arthritis of the knee. Curr Opin Orthop 11:26–34

    Article  Google Scholar 

  10. Kitson J, Weale AE, Lee AS, Maceachern AG (2001) Patellar tendon length following opening wedge high tibial osteotomy using an external fixator with particular reference to later total knee replacement. Injury 32:S-D-140–143

    Article  Google Scholar 

  11. Koshino T, Murase T, Saito T (2003) Medial opening-wedge high tibial osteotomy with use of porous hydroxyapatite to treat medial compartment osteoarthritis of the knee. J Bone Joint Surg [Am] 85:78–85

    Google Scholar 

  12. Naudie D, Bourne RB, Rorabeck CH, Bourne TJ (1999) Survivorship of the high tibial valgus osteotomy: a 10- to 22-year followup study. Clin Orthop 367:18–27

    PubMed  Google Scholar 

  13. Nizard RS, Cardinne L, Bizot P, Witvoet J (1998) Total knee replacement after failed tibial osteotomy: results of a matched-pair study. J Arthroplasty 13:847–853

    CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The authors thank all members of the Australian Knee Society, a special interest group of the Australian Orthopaedic Association, for their completion of the questionnaire. This work was presented at the Combined New Zealand and Australian Knee and Sports Surgery Society Meeting in Queenstown, New Zealand, October 2001. S.J.W. holds a National Health and Medical Research Council (Australia) CJ Martin Fellowship (Regkey no. 209169). K.M.C. holds a National Health and Medical Research Council (Australia) Health Professional Training Fellowship (Regkey no. 209168).

Author information

Authors and Affiliations

  1. Centre for Health, Exercise and Sports Medicine, School of Physiotherapy, University of Melbourne, Parkville, Victoria, Australia

    Stuart J. Warden, Hayden G. Morris, Kay M. Crossley, Peter D. Brukner & Kim L. Bennell

  2. Department of Orthopaedic Surgery, School of Medicine, Indiana University, 1120 South Drive, Indianapolis, IN 46202, USA

    Stuart J. Warden

Authors
  1. Stuart J. Warden
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hayden G. Morris
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kay M. Crossley
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Peter D. Brukner
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kim L. Bennell
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Stuart J. Warden.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Warden, S.J., Morris, H.G., Crossley, K.M. et al. Delayed- and non-union following opening wedge high tibial osteotomy: surgeons’ results from 182 completed cases. Knee Surg Sports Traumatol Arthrosc 13, 34–37 (2005). https://doi.org/10.1007/s00167-003-0485-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-003-0485-1

Keywords

Search

Navigation