A systematic approach to managing complications after proximal tibial osteotomies of the knee

• Valcarenghi Jérôme
• Vittone Giulio
• Mouton Caroline
• Coelho Leal Alexandre
• Ibañez Maximiliano
• Hoffmann Alexander
• Pape Dietrich
• Ollivier Matthieu
• Seil Romain

• Knee osteoarthritis Osteotomy Knee joint Internal fixation Joint-preserving surgery
• Knee osteoarthritis
• Osteotomy
• Knee joint
• Internal fixation
• Joint-preserving surgery

Proximal tibial osteotomy (PTO) is an effective procedure for active and young adult patients with symptomatic unicompartmental osteoarthritis and malalignment. They were considered technically demanding and prone to various complications related to the surgical technique, biomechanical or biological origin. Among the most important are hinge fractures and delayed or non-healing, neurovascular complications, loss of correction, implant-related problems, patellofemoral complaints, biological complications and changes in limb length. Being aware of these problems can help minimizing their prevalence and improve the results of the procedure. The aim of this narrative review is to discuss the potential complications that may occur during and after proximal tibial osteotomies, their origin and ways to prevent them.