Do You Need to Remove Plates and Screws After High Tibial Osteotomy?

High tibial osteotomy

Hello, after undergoing high tibial osteotomy approximately two years ago, is it necessary to have another surgery to remove the plates and screws? What are the potential consequences if they are not removed? Thank you.

Sharon, 30~39 year old female. Ask Date: 2020/10/22

Dr. Wang Shouji reply Orthopedics

Hello, if it has healed, you may consider removal, as current internal fixation devices are made of titanium alloy.
If you choose not to remove it, there is no significant issue.
Changhua Hospital cares about your health.
Sincerely, Dr.
Wang Shou-ji.

Reply Date: 2020/10/22

More Info

After undergoing a high tibial osteotomy (HTO), the decision to remove plates and screws typically depends on several factors, including the patient's healing progress, the presence of any symptoms, and the specific recommendations of the orthopedic surgeon. Generally, if the bones have healed properly and the patient is not experiencing any discomfort or complications, the removal of hardware may not be necessary.

In many cases, the plates and screws used in HTO are made from titanium, which is biocompatible and generally well-tolerated by the body. If the hardware is not causing any pain or functional issues, many surgeons recommend leaving it in place. However, if the patient experiences discomfort, pain, or any mechanical issues related to the hardware, removal may be considered.

The potential impacts of not removing the hardware include:
1. Chronic Pain or Discomfort: Some patients may experience ongoing pain or discomfort at the site of the hardware, particularly if the screws are prominent or if there is irritation of surrounding soft tissues.

2. Risk of Infection: Although rare, there is a potential risk of infection associated with retained hardware, especially if there is a break in the skin or if the patient undergoes future surgical procedures.

3. Hardware Failure: While uncommon, there is a possibility that the plates or screws could fail or break over time, which may necessitate surgical intervention.

4. Impact on Future Procedures: If additional surgeries are required in the future, the presence of hardware may complicate the surgical approach or increase the risk of complications.

5. Functional Limitations: In some cases, the presence of hardware may limit certain activities or movements, particularly in athletes or individuals engaged in high-impact sports.

If the decision is made to remove the hardware, the recovery time can vary. Generally, patients can expect a recovery period of about two to four weeks before returning to normal activities, including driving. However, this can depend on individual healing rates and the extent of the surgery performed.

In conclusion, the decision to remove plates and screws after a high tibial osteotomy should be made in consultation with your orthopedic surgeon, taking into account your specific circumstances, symptoms, and overall health. If you are experiencing any discomfort or have concerns about the hardware, it is advisable to discuss these with your surgeon, who can provide personalized recommendations based on your condition and recovery progress.

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