What are the risks of a high tibial osteotomy?

Risks specific to osteotomy

• Delayed union or non-union: the bone takes longer than expected to heal, or does not heal, and occasionally needs further surgery with bone graft
• Hinge fracture: the thin bridge of bone opposite the cut cracks, which may change the weight-bearing plan
• Loss of correction: the alignment drifts before the bone is solid
• Over- or under-correction: the final alignment differs from the plan
• Changes in kneecap height or tibial slope, which planning tries to minimise
• Plate or screw irritation under the skin, sometimes leading to removal later

General surgical risks

As with other leg operations, there is a risk of wound infection, deep infection around the plate, blood clots in the leg or lungs, bleeding, stiffness and persistent pain. Injury to the nerve on the outer side of the leg or to the blood vessels behind the knee is rare but serious, which is why the cut is made with protective techniques and X-ray guidance.

What raises or lowers your risk

Smoking and nicotine use are among the most important modifiable risk factors for poor bone healing. Poorly controlled diabetes, higher body weight, low vitamin D and very large corrections can also slow healing. Stopping smoking, controlling blood sugar, correcting vitamin D if low and following the weight-bearing plan carefully all help. In Qatar, low vitamin D is common despite the sunshine, so it is often checked before surgery.

Warning signs after surgery

Seek urgent assessment for fever, spreading redness or discharge from the wound, calf pain or swelling, chest pain or breathlessness, numbness or weakness in the foot, or a sudden increase in shin pain after a twist or fall. At follow-up visits at Aman Hospital, Dr. Gelber will check X-rays to make sure the bone is healing and the correction is holding.