Failures of Realignment Osteotomy
Operative Techniques in Sports Medicine
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© 2019 Elsevier Inc. Realignment osteotomies about the knee, consisting of proximal tibial and distal femoral osteotomies, are excellent methods for addressing mechanical axis deviation in the setting of unicompartmental knee osteoarthritis, ligament insufficiency, meniscus deficiency, and/or focal cartilage defects. These procedures, however, are not without complications. Complications encountered with theses osteotomies include cortical hinge fracture, tibial slope alterations, changes in patellar height, vascular injuries, and various early and late postoperative complications, including delayed unions and nonunions. This current concept article reviews the etiology, diagnosis, and management strategies for various complications related to high tibial and distal femoral osteotomies. In addition, technical strategies are provided for how to recognize and revise failed osteotomies in the setting of delayed unions and nonunions.