2019 ISAKOS Biennial Congress ePoster #1211
Complications Associated with Medial Opening-Wedge High Tibial Osteotomy Using a Locking Plate: A Multi-Center Study
Ki-Mo Jang, MD, PhD, Prof., Seoul KOREA, REPUBLIC OF
Yong In, MD, PhD, Seoul KOREA, REPUBLIC OF
Seung-Beom Han, MD, PhD, Seoul KOREA, REPUBLIC OF
Anam Hospital, Korea University College of Medicine , Seoul, KOREA, REPUBLIC OF
FDA Status Not Applicable
The overall complication rate was 29.7% after opening-wedge high tibial osteotomy using a locking plate, however most complications were minor. Major complications occurred in 8.6%, and the major complication group showed significantly worse clinical outcomes than the uncomplicated and minor complication groups.
To investigate complications following medial opening wedge high tibial osteotomy (OWHTO) using a locking plate. In addition, we aimed to compare postoperative outcomes between the complicated and the uncomplicated group.
The current study enrolled 209 patients who underwent medial OWHTO between 2010 and 2015. Patients with a follow-up period of at least two years were enrolled. Medical records and radiologic data were retrospectively reviewed. The complications were assessed up to postoperative two years and categorized into major and minor complications. The pre- and post-operative clinical statuses were assessed using the Western Ontario McMaster University Osteoarthritis Index (WOMAC).
The mean patient age was 56.4±5.9 years. Overall complication rate was 29.7%. Minor complications included undisplaced lateral hinge fracture (12.0%), hardware irritation (1.4%), displaced lateral hinge fracture (2.4%), delayed wound healing (1.9%), undisplaced lateral tibial plateau fracture (1%), and superficial wound infection (1%). Major complications were symptomatic hardware which needed hardware removal (4.8%), deep wound infection (1.9%), hardware failure with correction loss (1%), nonunion (0.5%), and early conversion to arthroplasty (0.5%). Most complications occurred intraoperatively (30.6%) and within 3 months postoperatively (40.3%). The major complication group showed a statistically higher WOMAC Index score than did other groups at postoperative 1 year (p < 0.013) and 2 years (p < 0.001).
The overall complication rate was 29.7%. Most complications were minor. The most common complication was undisplaced lateral hinge fracture. Major complications occurred in 8.6%. The major complication group showed significantly worse clinical outcomes than did the uncomplicated and minor complication groups.