![]() ![]() In addition, the role of aspirin, mechanical compressive devices, early mobilization and exercises such as immediate range of knee motion in decreasing the incidence of venous thromboembolism events after HTO has not been addressed. Whether anticoagulants should be routinely used postoperatively in patients who do not have significant risk factors for DVT is unknown. Several authors have recommended postoperative thromboprophylaxis programs for HTO that are similar to those used after Total Knee Arthroplasty (TKA) however, the appropriate program is not supported by clinical studies. High Tibial Osteotomy (HTO) is an operation that, although well-established, may be associated with complications including Deep Venous Thrombosis (DVT) that may occur in up to 5% of patients. ![]() Therefore, the necessity for anticoagulation after HTO in patients who do not have significant risk factors is questioned considering the side effects that may occur with these agents. The incidence of venous thromboembolism events was very low after HTO, regardless of the use of chemoprophylaxis. The risk of DVT was higher in closing-wedge osteotomies compared with opening-wedge osteotomies regardless of the use of anticoagulants. The relative risk of DVT was higher in patients that used anticoagulants compared with patients that did not use any form of chemoprophylaxis (1.99% and 1.11%, respectively P = 0.02). Anticoagulants were used in 1,110 patients and aspirin was used in 312 patients. The overall incidence rates of deep venous thrombosis and pulmonary embolism were 1.24% and 0.11%, respectively. One-hundred and seven studies were included (opening-wedge osteotomy 3923 knees and closing-wedge osteotomy 3172 knees). We conducted a systematic review of PubMed and Cochrane databases from 1999 through 2014 using search terms high tibial osteotomy HTO complications, HTO DVT, opening wedge osteotomy, and closing wedge osteotomy. This review investigated two questions: (1) what are the incidence rates of venous thromboembolism events after HTO, and (2) what is the routine use of anticoagulants required in standard-risk patients? There is no consensus regarding postoperative thromboprophylaxis, including the routine use of anticoagulants. High Tibial Osteotomy (HTO) is an operation that, although well-established, may be associated with complications including venous thromboembolism events.
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