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2022, Vol. 26 ›› Issue (36): 5849-5856

Implant-related errors and complications in medial open-wedge high tibial osteotomy

Pan Jianke1, Zhao Di1, 2, Jin Xiao3, Yang Weiyi1, Luo Minghui1, Liu Jun1, 2, 4, 5, Han Yanhong1, Cao Houran1   

  1. 1Department of Sports Medicine, Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou 510120; 2Bone and Joint Degeneration and Injury Research Team, Guangzhou 510120; 3Department of Chinese Medicine, First Affiliated Hospital of Jinan University, Guangzhou 510632; 4Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou 510095; 5Fifth Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou 510405

  • Received:2021-08-24 Accepted:2021-12-07 Online:2022-12-28 Published:2022-04-27

  • Contact: Yang Weiyi, Chief physician, Professor, Master’s supervisor, Department of Sports Medicine, Second Affiliated Hospital, Guangzhou University of Chinese Medicine & Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, Guangdong Province, China

  • About author:Pan Jianke, MD, Associate chief physician, Department of Sports Medicine, Second Affiliated Hospital, Guangzhou University of Chinese Medicine & Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, Guangdong Province, China

  • Supported by:

    The Ministry of Industry and Information Technology and the National Health and Family Planning Commission “Orthopedic Surgery Robot Application Center” Construction Project, No. 2017MHDOSR1008 (to LJ); Guangdong Provincial Department of Finance Project (Management System of Traditional Chinese Medicine for Middle-Aged and Elderly Degenerative Knee Osteoarthritis, No. [2014]157; Traditional Characteristic Therapy Inheritance and Innovation Research of Traditional Chinese Medicine Orthopedics and Traumatology, No. [2018]8) (to LJ); Science and Technology Special Research of Guangdong Provincial Hospital of Traditional Chinese Medicine (Clinical Experience Inheritance Research of Lingnan Traumatology Famous Traumatology Experts, No. YK2013B2N19; Systematic Review of Clinical Studies of Traditional Chinese Medicine in the Treatment of Osteoarthritis and its GRADE Evidence Quality Evaluation Study, No. YN2015MS15 (to LJ)


Abstract: BACKGROUND: Medial open wedge high tibial osteotomy is one of important methods in the treatment of medial compartment knee osteoarthritis and also an important part of knee preservation therapy. Intraoperative errors and postoperative complications are important factors affecting the success of the operation.
OBJECTIVE: To summarize the common errors and complications of medial open-wedge high tibial osteotomy and analyze the causes.
METHODS: A retrospective analysis was performed in patients who underwent primary medial open-wedge high tibial osteotomy for anterior medial osteoarthritis of the knee in Department of Sports Medicine, Guangzhou University of Chinese Medicine from April 2017 to August 2021 through the hospital medical records information management system. The typical cases of intraoperative errors and postoperative complications were summarized and analyzed.
RESULTS AND CONCLUSION: (1) Common errors and complications of 12 kinds of medial open-wedge high tibial osteotomy were found, including short or long screw selection, forward or upward plate placement, hinge fracture, deviation of osteotomy line positioning from actual osteotomy, insufficient or too much force line correction, bone nonunion, fracture displacement, bone nonunion, nail withdrawal, postoperative infection, postoperative acute intermuscular venous thrombosis, and postoperative wound swelling and pain. (2) After analyzing and treating 12 kinds of common errors and complications in clinic, most patients had achieved good results. (3) We hoped to share these experiences and lessons with the majority of colleagues, and reduce the occurrence of intraoperative errors and postoperative complications as far as possible, as well as improve medical safety and postoperative satisfaction of patients.
Key words: medial open-wedge high tibial osteotomy, knee osteoarthritis, error, complication, infection


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