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Does obesity and nicotine abuse influence the outcome and complication rate after open-wedge high tibial osteotomy? A retrospective evaluation of five hundred and thirty three patients

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Abstract

Purpose

Nicotine abuse and obesity are well-known factors leading to common post-operative complications. However, their influence on the outcome after high tibial osteotomy is controversial. Thus, the aim of this study was to evaluate their effect on the clinical outcome with particular regard to bone non-union and local complications.

Methods

The functional outcome after open-wedge high tibial osteotomy using the TomoFix® plate was assessed by means of the 12-item Oxford knee score in a multicentre study. In addition the intra- and post-operative complications were determined.

Results

Of 533 eligible patients, 386 were interviewed after a mean follow-up of 3.6 years. The median Oxford knee score was 43 points (max. 48 points). Six per cent of these patients experienced at least one local post-operative complication. Patients with a body mass index (BMI) of up to 25 and between 25 and 30 had a higher mean score by 3.5 and 1.8 points, respectively, compared with those having a BMI of more than 30 showing a score of 37.5. No correlation was observed between smoking and the functional outcome. Smoking habits, BMI, the absolute patient weight and the interaction term between smoking and BMI were not significant with reference to the complication rate.

Conclusions

This study reveals favourable mid-term results after high tibial osteotomy in varus osteoarthritis even in patients who smoked and obese patients. The indication in patients with a BMI above 30 should be handled with care due to the slightly inferior outcome, although the complication rate was not increased in these patients.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Hanover Medical School, Anna-von-Borries-Str. 1-7, 30625, Hanover, Germany

    Stephanie Floerkemeier

  2. Private Clinic Sonnmatt Luzern, Hemschlennstrasse 15, 6000, Lucerne, Switzerland

    Alex E. Staubli

  3. BG Unfallklinik Tübingen, Schnarrenbergstr. 95, 72076, Tübingen, Germany

    Steffen Schroeter

  4. AO Clinical Investigation and Documentation, AO Foundation, Stettbachstr. 6, 8600, Dübendorf, Switzerland

    Sabine Goldhahn

  5. Sports Clinic Germany, Uhlemeyerstr. 16, 30175, Hanover, Germany

    Philipp Lobenhoffer

Authors
  1. Stephanie Floerkemeier
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  2. Alex E. Staubli
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  3. Steffen Schroeter
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  4. Sabine Goldhahn
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  5. Philipp Lobenhoffer
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Correspondence to Stephanie Floerkemeier.

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Floerkemeier, S., Staubli, A.E., Schroeter, S. et al. Does obesity and nicotine abuse influence the outcome and complication rate after open-wedge high tibial osteotomy? A retrospective evaluation of five hundred and thirty three patients. International Orthopaedics (SICOT) 38, 55–60 (2014). https://doi.org/10.1007/s00264-013-2082-3

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  • DOI: https://doi.org/10.1007/s00264-013-2082-3

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