Evidence map›Paper›PMID 35112179›Full record

ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2022

Complications after high tibial osteotomy and distal femoral osteotomy are associated with increasing medical comorbidities and tobacco use.

Natalie K Kucirek, Christopher Anigwe, Alan L Zhang, C Benjamin Ma, Brian T Feeley, Drew A Lansdown

Abstract read
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In one paragraph

Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
2.6field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.

  1. Pooled it
  2. Medial open wedge high tibial osteotomy is a viable option in young patients with advanced arthritis in a long-term follow-up.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Natalie K KucirekUniversity of California, San Francisco School of Medicine, 533 Parnassus Ave, San Francisco, CA, 94143, USA.ORCID http://orcid.org/0000-0003-0303-6423
Christopher AnigweUniversity of California, San Francisco School of Medicine, 533 Parnassus Ave, San Francisco, CA, 94143, USA.
Alan L ZhangDepartment of Orthopaedic Surgery, University of California, San Francisco, 1500 Owens St, San Francisco, CA, 94158, USA.
C Benjamin MaDepartment of Orthopaedic Surgery, University of California, San Francisco, 1500 Owens St, San Francisco, CA, 94158, USA.
Brian T FeeleyDepartment of Orthopaedic Surgery, University of California, San Francisco, 1500 Owens St, San Francisco, CA, 94158, USA.
Drew A LansdownDepartment of Orthopaedic Surgery, University of California, San Francisco, 1500 Owens St, San Francisco, CA, 94158, USA.
University of California, San Francisco · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe purpose of this study was to assess complications, reoperations, and their risk factors at 90 days and 2 years after high tibial osteotomy (HTO) and distal femoral osteotomy (DFO) in a national cohort.

methodsThe PearlDiver Mariner Dataset was queried using International Classification of Diseases (ICD) and Current Procedural Terminology (CPT) codes for HTO and DFO, complications, and subsequent surgery. Minimum follow-up was 2 years and complications were assessed at 90 days and 2 years. Hospital readmission in the first 90 days was also assessed. Univariate and multiple logistic regression were utilized to identify risk factors for complications and re-operation.

resultsThe 90-day and 2-year complication rates after HTO (n = 1780) were 11.6% and 31.7%, compared to 21.5% (p < 0.0001) and 41.5% (p = 0.0001) after DFO (n = 446). Infection was the most frequent early (90-day) complication for both HTO and DFO cohorts, while hardware problems were most common at 2 years. Increasing Elixhauser Comorbidity Index (ECI) was associated with increased odds of infection, readmission, and hardware-associated complications in both cohorts. Gender and tobacco use were also associated with various complications after HTO. At 2 years, 23.7% of HTO patients and 26.2% of DFO patients had undergone subsequent surgery. Hardware removal occurred in 16.4% of HTO and 18.4% of DFO patients (n.s.), while 4.5% of HTO and 5.2% of DFO patients underwent total knee arthroplasty (TKA) within 2 years (n.s.).

conclusionHTO and DFO have substantial complication rates in the short and mid term, with a higher rate of overall complications observed after DFO as compared to the HTO cohort. After both procedures, roughly one quarter of patients will undergo subsequent surgery within 2 years. Patients with tobacco use and numerous medical co-morbidities may not be optimal candidates due to increased complication rates. Elixhauser Comorbidity Index (ECI) may be an useful tool for risk assessment prior to surgery. LEVEL OF EVIDENCE: Retrospective cohort study, III.

Indexed as

Osteoarthritis, KneeComorbidityHumansKnee JointOsteotomyRetrospective StudiesTibiaTobacco UseTreatment OutcomeComplicationsDistal femoral osteotomyElixhauser Comorbidity IndexHigh tibial osteotomyReoperation

Identifiers

PMID35112179
OpenAlexW4210301153

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.