A Rare Complication: Severe Valgus Deformity After Open-Wedge High Tibial Osteotomy

J Orthop Case Rep. 2024 Apr;14(4):84-89. doi: 10.13107/jocr.2024.v14.i04.4368.

Abstract

Introduction: In the treatment of medial gonarthrosis, the high tibial osteotomy (HTO) is recognized as an effective joint-sparing surgical procedure. Severe valgus deformity is not a common complication after HTO. There are no cases in the literature reporting valgus deformity of 10° or more after HTO.

Case report: An open-wedge HTO was performed on a 57-year-old female patient due to left knee pain and varus deformity. In this case, a progressive and severe valgus deformity occurred during follow-up. The severe valgus deformity was then corrected using an inverted V-shaped (hemi-closing, hemi-opening) HTO.

Conclusion: Valgus deformity after HTO is not common. There are various factors that can lead to post-HTO valgus deformity; although no cases of valgus deformity exceeding 10° have been described. Intra-operative releasing of the superficial medial collateral ligament and associated lateral hinge fracture was a risk factor for overcorrection. This case aims to uncover the factors contributing to the development of severe valgus deformity subsequent to HTO and to present solutions for its management.

Keywords: Case report; biplanar osteotomy; high tibial osteotomy; valgus deformity.

Publication types

  • Case Reports