Background and purpose
High tibial open wedge valgisation osteotomy (HTO) is a widely used procedure for the treatment of unicompartimental osteoarthritis
of the knee. Instead of the classical paramedian longitudinal skin incision, some advocate an oblique incision, in order to
get a better exposure of the postero-medial aspect of the tibial head, while reducing strain on the soft tissues. Risk factors
for surgical site infection were analysed.
Methods
Retrospective analysis of all cases of HTO performed in a single institution between January 2000 and June 2006.
Results
A total of 106 patients underwent 110 HTO during the study period. The standard longitudinal incision had been used in 90,
oblique incision in 20 cases. Four infections occurred, all with an oblique incision. This was the only factor showing a statistical
significant association with surgical site infection (P = 0.001).
Interpretation
The oblique incision is the only parameter with statistical significant association with infection after HTO. As this study
type cannot prove causality, it is recommended to perform oblique incision only after careful evaluation of risks and benefits.
Keywords High tibial osteotomy - Infection - Risk factors - Incision