The degree of correction in open-wedge high tibial osteotomy compromises bone healing: A consecutive review of 101 cases

Background: The bone healing in open-wedge high tibial osteotomy (OWHTO) proceeds gradually by a filling of the osteotomy gap. This can comprise several risk factors. Methods: A retrospective study analysed the clinical and radiological course of 101 consec-utive OWHTOs in 96 patients. The following risk factors were considered: age, body mass index, tobacco consumption, amount of tobacco consumption, severity of comorbidities, infection of the surgical area, occurrence of a lateral hinge fracture and the degree of cor-rection. The bone healing was evaluated by using the modified Radiographic Union Score for Tibial fractures (RUST). Results: A disturbance in bone healing was observed in 16 of the 101 osteotomies. Binary logistic regression analysis showed a correlation between the angle of the opening wedge and the development of a disturbance in bone healing (P = 0.002). The odds ratio indicated an increase in the risk of a disturbance in bone healing of 56% with each additional degree of correction. For the risk factor 'age' a statistical trend was recognizable (P = 0.077) with the risk of a disturbance in bone healing in higher age. Conclusion: Lateral hinge fractures seem not to have a detrimental effect on the filling of the osteotomy gap. An increase in the opening wedge bears the risk of a disturbance in bone healing. (c) 2021 Elsevier B.V. All rights reserved.