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May smokers and overweight patients be treated with a medial open-wedge HTO? Risk factors for non-union

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

Abstract

Purpose

The purpose of this retrospective study was to investigate the rate of non-union after medial open-wedge high tibial osteotomy (HTO) with the Tomofix® plate. In addition, risk factors with a possible influence on the development of a non-union were analysed.

Methods

Between 2006 and 2008, a total of 186 medial open-wedge HTOs were performed in 182 patients.

Results

Ten cases of non-union (5.4%) were recorded. Risk factors with a statistically significant influence on the development of a non-union included smoking, body mass index and fracture of the lateral cortical hinge. No influence was detected for the factors age, degree of correction, concomitant diseases, postoperative complications, drug use, additionally performed procedures and use of a temporary lag screw.

Conclusion

Within this study, it could be demonstrated that the rate of non-union in medial open-wedge HTO is not higher than in the lateral closed-wedge technique. Concerning the detected risk factors, the importance of the preservation of the lateral cortex is emphasised. In addition, it is necessary to discuss the risk of non-union with smokers and overweight patients when planning the therapy. Finally, it should be considered to perform iliac crest bone grafting in these high-risk patients a priori.

Level of evidence

IV.

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Authors and Affiliations

  1. Department of Orthopaedic Sports Medicine, Klinikum rechts der Isar, Technical University of Munich, Connollystraße 32, 80809, Munich, Germany

    Gebhart Meidinger, Andreas B. Imhoff, Martin Sauerschnig & Stefan Hinterwimmer

  2. Department of Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany

    Jochen Paul

  3. Department of Orthopedics, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany

    Chlodwig Kirchhoff

Authors
  1. Gebhart Meidinger
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  2. Andreas B. Imhoff
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  3. Jochen Paul
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  4. Chlodwig Kirchhoff
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  5. Martin Sauerschnig
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  6. Stefan Hinterwimmer
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Correspondence to Andreas B. Imhoff.

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Meidinger, G., Imhoff, A.B., Paul, J. et al. May smokers and overweight patients be treated with a medial open-wedge HTO? Risk factors for non-union. Knee Surg Sports Traumatol Arthrosc 19, 333–339 (2011). https://doi.org/10.1007/s00167-010-1335-6

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  • DOI: https://doi.org/10.1007/s00167-010-1335-6

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