Complications of high tibial osteotomy and internal fixation with staples

Wildner, M.; Peters, A. C. B.; Hellich, J; Reichelt, A.

doi:10.1007/bf00571479

Cited by 27 publications

(22 citation statements)

References 10 publications

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“…No study has been able to determine a relationship between outcome and patients' age [57]. Most surgeons agree that in cases of medial gonarthrosis a slight overcorrection of 2 to 5 degrees toward valgus leads to better long-term results [2,58]. This procedure generally provides good relief of pain and restoration of function in 80-90% of patients at five years and 50-65% at ten years [2,3,7,29,35,55,59,60].…”

Section: Results Of Lateral Closing Wedge High Tibial Osteotomy For Vmentioning

confidence: 99%

Closing wedge osteotomy of the tibia and the femur in the treatment of gonarthrosis

Sherman

Cabanela

2009

International Orthopaedics (SICOT)

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New developments in osteotomy techniques and methods of fixation have caused a renewed interest in closing wedge osteotomies of the tibia and femur in the treatment of gonarthrosis. The rationale, definition and techniques of closing wedge tibial and femoral osteotomies in the treatment of gonarthrosis are discussed. The principal indications include unicompartmental medial and much less so, varus knee gonarthrosis and unicompartmental lateral or valgus knee gonarthrosis with a well-maintained range of motion in patients who are physiologically young. Newer techniques have provided more rigid fixation and improved accuracy of correction.

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Section: Results Of Lateral Closing Wedge High Tibial Osteotomy For Vmentioning

confidence: 99%

Closing wedge osteotomy of the tibia and the femur in the treatment of gonarthrosis

Sherman

Cabanela

2009

International Orthopaedics (SICOT)

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“…Two superficial wound infections healed after antibiotic therapy without any consequences. The cause of the haemarthrosis was never clarified [21,23].…”

Section: Discussionmentioning

confidence: 99%

“…The fact that knee replacement probably has a higher complication rate and a poorer clinical outcome when it follows corrective osteotomy must also be borne in mind [11,19]. Various types of internal and external fixation have been used [3,5,6,21,23]. Nevertheless, the studies available on the effectiveness of high tibial corrective osteotomy are of limited value as they either fail to consider the indication or refer to a number of different surgical techniques.…”

Section: Introductionmentioning

confidence: 99%

High tibial osteotomy for valgus and varus deformities of the knee

Leutloff

Tobian

Perka

2001

International Orthopaedics (SICOT)

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In 53 patients with a mean age of 38 (17-73) years, 71 high tibial osteotomies were performed. Twenty-three patients had no radiological signs of osteoarthrosis (Ahlbäck grade 0), whereas 26 patients had primary and 22 patients secondary osteoarthritis. Follow-up was 10.5 (5.8-16.6) years. The patients without radiological osteoarthrosis achieved almost exclusively good or very good scores using the Lysholm-Gillquist (96%) and the Insall scale (83%). By contrast, only 29% of the patients with radiological osteoarthritis achieved good or very good scores. Whether the patient had primary or secondary osteoarthrosis was of no influence. Neither was the preoperative axial deviation.Résumé Chez 53 patients, d'âge moyen 38 (17-73) ans, 71 ostéotomies hautes du tibia ont été éffectuées. Vingttrois malades n'avaient pas de signes radiologiques d'arthrose (Ahlbäck grade 0), alors que 26 malades avaient une arthrose primaire et 22 une arthrose secondaire. Le suivi était de 10.5 (5.8-16.6) années. Les malades sans arthrose radiologique ont atteints presque exclusivement des bons ou très bons scores selon les échelles de Lysholm-Gillquist (96%) et d' Insall (83%). Par contraste, seulement 29% des malades avec arthrose radiologique ont atteints de bons ou très bons scores. Le caractère primaire ou secondaire de l'arthrose et la déviation axiale préopératoire n'avaient aucune influence.

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“…Wildner et al (6), studied the HTO operation in 182 patients and used U-staples for fixation except in four patients. 9 patients (4.9%) had transient peroneal nerve palsy.…”

Section: Discussionmentioning

confidence: 99%

Investigation of Neurologic Complications in Closed Wedge High Tibial Valgization Osteotomy Technique by Using Electrophysiological Methods

Yücel¹,

Mutlu²,

Kömür³

et al. 2014

JAREM

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Objective: The aim of this study is to investigate neurologic complications of closed wedge valgization osteotomy technique using electrophysiological methods.Methods: Eleven extremities of 11 patients (mean age 52.75±5.39) with medial gonarthrosis and varus deformity were included. All patients underwent closed wedge valgization osteotomy in order to correct varus deformity. Results:The post-operative amplitude of nervus peroneus superficialis significantly decreased when compared to pre-operative amplitude. The mean pre-operative N. peroneus superficialis amplitude was 12.77, whereas it reduced to 5.44 postoperatively (p<0.05). Other nerve conduction velocity investigations showed no significant differences between pre-and post-operative values. A Needle Electromyography (EMG) study demonstrated neurogenic involvement in 4 patients after surgery. All of these 4 patients had denervation in the m.extensor hallucis longus needle EMG study. In 2 patients, the musculus tibialis anterior needle EMG study showed neurogenic involvement. One of these had denervation. One patient showed denervation in the m.extensor digitorum brevis needle EMG study. Conclusion:Although fibula osteotomy used in the closed wedge osteotomy technique was applied from the safe zone, electrophysiological investigations suggested that this zone may, in fact, not be safe. (JAREM 2014; 1: 12-7) Key Words: Closed wedge, high tibial osteotomy, valgization osteotomy, peroneal nevre ÖZET Amaç: Bu çalışmanın amacı kapalı kama valgizasyon osteotomisi tekniğinin nörolojik komplikasyonlarını elektrofizyolojik yöntemlerle araştırmaktır.Yöntemler: Ortalama yaşları 52,75 (±5,39) olan varus deformitesi bulunan medial gonartrozlu 11 hastanın 11 ekstremitesi çalışmaya alınarak mevcut varus deformitelerini düzeltme amacıyla uygulanan kapalı kama valgizasyon osteotomisi uygulanan hasta grubu çalışmaya dahil edilmiştir. Bulgular: Nervus peroneus süperfisialis amplitüdü incelendiğinde ameliyat öncesine göre ameliyat sonrası ortalama olarak anlamlı şekilde azalma saptanmıştır. Ameliyat öncesi ortalama N. peroneus süperfisialis amplitüdü 12,77 iken ameliyat sonrası ortalama değer 5,44 olarak bulunmuştur (p<0,05). Diğer sinir ileti hızları incelemelerinde ise ameliyat öncesi ve sonrası arasında istatiksel olarak anlamlı fark saptanmamıştır. İğne Elektromyografi (EMG) çalışmasında ise 4 hastada ameliyat sonrası incelemede nörojen tutulum saptanmıştır. Dört hastanın tamamında m. ekstansör hallusis longus iğne EMG çalışmasında denervasyon saptanmıştır. İki hastanın musculus tibialis anterior iğne EMG çalışmasında nörojen tutulum saptanmıştır. Bunlardan birinde denervasyon saptanmıştır. Bir hastada m. ekstansör dijitorum brevis iğne EMG çalışmasında denervasyon saptanmıştır.Sonuç: Kapalı kama osteotomi tekniğinde kullanılan fibula osteotomisi güvenli bölgeden yapılmasına rağmen elektrofizyolojik inceleme sonuçları bu bölgenin güvenli olduğu konusunda şüphe uyandırmaktadır. (JAREM 2014; 1: 12-7) Anahtar Sözcükler: Kapalı kama, yüksek tibial osteotomi, valg...

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Complications of high tibial osteotomy and internal fixation with staples

Cited by 27 publications

References 10 publications

Closing wedge osteotomy of the tibia and the femur in the treatment of gonarthrosis

Closing wedge osteotomy of the tibia and the femur in the treatment of gonarthrosis

High tibial osteotomy for valgus and varus deformities of the knee

Investigation of Neurologic Complications in Closed Wedge High Tibial Valgization Osteotomy Technique by Using Electrophysiological Methods

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