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Perioperative complications in osteotomies around the knee: a study in 858 cases

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Eight hundred and fifty-eight consecutive osteotomies around the knee joint were analyzed retrospectively to detect intra- and early postoperative complications in a period of 4 weeks postoperative. Indications for osteotomy were unilateral gonarthritis or torsional deformities resulting in femoropatellar instability or anterior knee pain.

Materials and methods

Etiology of deformity, technique and mode of correction and level of osteotomy were registered. Complications were detected and divided in minor complication (superficial wound infection, and deep-vein thrombosis) and major complication (compartment syndrome, deep infection, and vascular lesion).

Results

Fifteen major (1.7%) and 17 minor complications (2.0%) were detected: 5 vascular lesions (0.58%), 4 compartment syndromes (0.47%) and 6 deep infections (0.70%), 14 superficial wound infections (1.6%) and 3 deep-vein thrombosis (0.35%). In posttraumatic osteotomies and continuous corrections, risk for a superficial wound infection was significantly higher and with osteoclasia risk for vascular lesion was higher compared to osteotomy with oscillating saw. No difference was found for anatomical level of osteotomy and for the other complications in terms of etiology of deformity, technique of osteotomy and mode of correction.

Conclusion

Osteotomy around the knee is a safe procedure in the treatment of unicompartmental gonarthritis in terms of intra- and postoperative complications. Major complications are rare. Pit falls for compartment syndromes (LCW and torsional corrections) have to kept in mind. There is no difference in frequency of complications between HTO and supracondylar osteotomies. Risk for superficial wound infection is higher in posttraumatic osteotomies and with continuous corrections. Osteoclasia contains a higher risk for vascular lesion compared to oscillating saw.

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Authors and Affiliations

  1. Klinik Für Orthopädie Und Unfallchirurgie Sozialstiftung Bamberg, Buger Str. 80, 96049, Bamberg, Germany

    Felix Ferner, Ilona Schubert, Maximilian Schenke, Wolf Strecker & Joerg Dickschas

  2. Klinik für Orthopädie, Universität Rostock, Schillingallee 35, 18057, Rostock, Germany

    Christoph Lutter

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  1. Felix Ferner
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  2. Christoph Lutter
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  3. Ilona Schubert
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  6. Joerg Dickschas
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Correspondence to Felix Ferner.

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All the procedures performed in this study were in accordance with the ethical standards of the institutional research committee (ethical committee Friedrich-Alexander-University Erlangen, reference number 38_15 Bc).

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Ferner, F., Lutter, C., Schubert, I. et al. Perioperative complications in osteotomies around the knee: a study in 858 cases. Arch Orthop Trauma Surg 142, 769–775 (2022). https://doi.org/10.1007/s00402-020-03696-w

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  • DOI: https://doi.org/10.1007/s00402-020-03696-w

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