Editorial Commentary: Locking Plate Removal Is Safe and May Improve Function 1 Year After Medial Opening Wedge High Tibial Osteotomy

Abstract

The development of angular stable locking late fixation in realignment osteotomy has resulted in the ability to be more aggressive with weight bearing and rehabilitation after high tibial osteotomy. One of the downsides of some of these plate fixators is the degree of soft-tissue irritation and discomfort that can be experienced by many patients, resulting in the need for hardware removal. Studies have shown greater than 50% of patients requiring hardware removal with no resulting loss of correction, although there may be cultural reasons for the higher number, not solely attributable to the symptom profile. It is encouraging to see that after 1 year postoperatively, hardware removal after high tibial osteotomy not only is safe but also results in a clinically important improvement in pain and function, with progressive bone healing out to 2 years.