Incidence of DVT following medial open wedge high tibial osteotomy (MOW-HTO): Prospective study

Abstract

Background: High tibial osteotomy (HTO) is an established procedure for the treatment of medial compartment osteoarthritis of knee with varus deformity and it has become a popular procedure. In elective knee surgeries such as total knee arthroplasty (TKA) and HTO, it is well recognized that those are associated with a substantial risk of developing deep vein thrombosis (DVT) which carries a risk of fatal pulmonary embolism. Materials and Methods: In this prospective study, we analysed 110 patients, operated with MOW-HTO, for medial compartment osteoarthritis, for evidence of DVT, after dividing the patients into a trial group which received chemoprophylaxis in the form of Fondaparinux and a control group which did not receive any DVT prophylaxis. Results: At postoperative day 6, overall DVT was diagnosed in 6 (15.78%) patients in control group and in 5 (7.1%) patients in fondapariux group (P > 0.05). All patients with DVT were asymptomatic clinically. Proximal DVT was diagnosed in only 1 patient (2.5%) in control group, however none of the patient in fondapariux group had proximal DVT (P>0.05). There was no case of symptomatic DVT and symptomatic PE in either group during the entire study period. Among demographic characteristic, age and body mass index (BMI) showed association (P<0.5) with postoperative incidences of DVT in univariate analysis, however multivariate analysis showed patients with age more than 55 years had significant correlation with post- operative DVT. Incidences of overall DVT diagnosed by Doppler USG and CT venography were not different statistically. Conclusion: Our data demonstrates that the incidences of DVT following MOW-HTO were lower than incidences following TKA in Asian patients. therefore it would not be advisable to use routine chemoprophylaxis following MOW-HTO in a low DVT incidence population