A systematic approach to managing complications after proximal tibial osteotomies of the knee

Jérôme Valcarenghi; Giulio Vittone; Caroline Mouton; Alexandre Coelho Leal; Maximiliano Ibañez; Alexander Hoffmann; Dietrich Pape; Matthieu Ollivier; Romain Seil

doi:10.1186/s40634-023-00708-7

A systematic approach to managing complications after proximal tibial osteotomies of the knee

J Exp Orthop. 2023 Dec 6;10(1):131. doi: 10.1186/s40634-023-00708-7.

Authors

Jérôme Valcarenghi^{1

2}, Giulio Vittone^{1

3}, Caroline Mouton^{1

4}, Alexandre Coelho Leal^{1

5}, Maximiliano Ibañez^{1

6}, Alexander Hoffmann^{1

4}, Dietrich Pape^{1

4}, Matthieu Ollivier^{7

8}, Romain Seil^{9

10

11}

Affiliations

¹ Department of Orthopaedic Surgery, Centre Hospitalier de Luxembourg - Clinique d'Eich, Luxembourg, Luxembourg.
² Department of Orthopaedic Surgery, Centre Hospitalier Universitaire d'Ambroise Paré, Mons, Belgium.
³ Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.
⁴ Luxembourg Institute of Research in Orthopaedics, Sports Medicine and Science (LIROMS), Luxembourg, Luxembourg.
⁵ Department of Orthopedics and Traumatology, Hospital del Mar, Barcelona, Spain.
⁶ Institut Català de Traumatologia I Medicina de L'Esport (ICATME), Hospital Universitari Quiron-Dexeus, Carrer Sabino de Arana, 5-19, 08028, Barcelona, Spain.
⁷ Department of Orthopedics and Traumatology, Institute of Movement and Locomotion, St Marguerite Hospital, Marseille, France.
⁸ Department of Orthopedics and Traumatology, Institute for Locomotion, APHM, CNRS, ISM, Sainte- Marguerite Hospital, Aix Marseille University, Marseille, France.
⁹ Department of Orthopaedic Surgery, Centre Hospitalier de Luxembourg - Clinique d'Eich, Luxembourg, Luxembourg. rseil@yahoo.com.
¹⁰ Luxembourg Institute of Research in Orthopaedics, Sports Medicine and Science (LIROMS), Luxembourg, Luxembourg. rseil@yahoo.com.
¹¹ Human Motion, Orthopaedics, Sports Medicine and Digital Methods (HOSD), Luxembourg Institute of Health, Luxembourg, Luxembourg. rseil@yahoo.com.

Abstract

Proximal tibial osteotomy (PTO) is an effective procedure for active and young adult patients with symptomatic unicompartmental osteoarthritis and malalignment. They were considered technically demanding and prone to various complications related to the surgical technique, biomechanical or biological origin. Among the most important are hinge fractures and delayed or non-healing, neurovascular complications, loss of correction, implant-related problems, patellofemoral complaints, biological complications and changes in limb length. Being aware of these problems can help minimizing their prevalence and improve the results of the procedure.The aim of this narrative review is to discuss the potential complications that may occur during and after proximal tibial osteotomies, their origin and ways to prevent them.

Keywords: Internal fixation; Joint-preserving surgery; Knee joint; Knee osteoarthritis; Osteotomy.

Publication types

Review