Adverse Event Rates and Classifications in Medial Opening Wedge High Tibial Osteotomy

Abstract

The most common adverse event in MOW HTO requiring extended nonoperative treatment (class 2) is delayed union (12%). The rate of severe adverse events requiring additional surgery and/or long-term medical care (class 3) is low (7%).

Treatment of chronic (>1 year) fracture nonunion: Heal rate in a cohort of 767 patients treated with low-intensity pulsed ultrasound (LIPUS)

“…Approximately 93% of patients heal successfully after fracture [1][2][3][4]. However, certain fracture types and certain patient characteristics make a fracture more prone to nonunion; for example, one report concluded that 16% of patients with open fracture develop delayed union or nonunion [5].…”

Fixator-assisted Technique Enables Less Invasive Plate Osteosynthesis in Medial Opening-wedge High Tibial Osteotomy: A Novel Technique

“…Lateral tibial plateau fracture during opening-wedge high tibial osteotomy is uncommon, but it is a severe complication when it occurs. Marti et al [25] reported a 3% of incidence in series of 323 segments. We experienced no tibial plateau fracture in our case series.…”

“…Conventional opening-wedge high tibial osteotomy is associated with complications including implant breakage, lateral cortical fracture, fracture of the lateral tibial plateau, increased posterior tibial slope, delayed union or nonunion, delayed would healing, and deep infection [2,4,9,15,25,26]. Since angle-stable locking plates were introduced, implant-related complications have been reduced considerably [2,12].…”

“…Since angle-stable locking plates were introduced, implant-related complications have been reduced considerably [2,12]. However, soft tissue problems, delayed union or nonunion, and deep infection still are reported to be relatively frequent [9,12,15,23,25] in conventional opening-wedge high tibial osteotomy, which may result from extensive soft tissue exposure to protect posterior neurovascular structures or to apply the plate while maintaining a distractor in place during the surgery.…”

Die Fraktur der Gegenkortikalis bei der aufklappenden Osteotomie des Tibiakopfes

“…Es zeigte sich rasch, dass nicht Komplikationen wie Infektionen oder Arthrofibrose im Vordergrund stehen sondern Themen wie Präzision [12], Korrekturverlust [13], Pseudarthrose [14], Implantatversagen [13,15,16], Knochenheilung [17] und Fraktur der lateralen Kortikalis oder Tibiaplateaufrakturen [14,[17][18][19] eine wesentliche Rolle spielen. Die Fraktur der lateralen Kortikalis wird mit einer Rate von 11 % [20] bis 35 % [21] berichtet.…”