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Purpose This study aimed to investigate preoperative sports participation and postoperative clinical outcomes including a return to sports (RTS) after hybrid closed-wedge high tibial osteotomy (CWHTO) for medial compartment osteoarthritis of the knee. Characteristic of Hybrid CWHTO was deined as extra-articular lateral closed and medial open wedge osteotomy. Methods The patients who underwent hybrid CWHTO from January 2016 to December 2018 were retrospectively reviewed and divided them into sports and non-sports groups. The preoperative demographic and radiographic characteristics were compared in both groups. And the clinical outcomes including the Japanese Orthopaedic Association (JOA) score, visual analogue scale (VAS), Lysholm score, University of California at Los Angeles (UCLA) activity score, and RTS in the sports group were also investigated. Statistical analysis was performed for comparisons among the preoperative factors between the two groups. Inluence of sports impact and bone union of ibular osteotomy was also statistically investigated for RTS. Results Of the 161 knees (129 patients; 46 males, 83 females), 20 knees (16 patients; 13 males, 3 females; 12.3%) belonged to sports group. Although there were no signiicant diferences regarding the age and radiographic parameters, there were signiicant diferences in the body mass index and proportion of males between both groups. The JOA, VAS, Lysholm, and UCLA activity scores signiicantly improved after surgery. RTS was 80% at a mean duration of 7.2 ± 3.1 months. RTS in the high-impact sports group was signiicantly lower than that in the low-impact sports group (high-impact 60% vs. low-impact 100%, p = 0.043). There was no signiicant diference in RTS regarding bone union after ibular osteotomy. ConclusionThe clinical outcomes including RTS were satisfactory in patients with hybrid CWHTO. Level of evidence IV.

Osteoporotic vertebral fractures in older patients impair activities of daily living because of low back pain and abnormal posture. Assessing pain using self-reported assessment tools is difficult, especially in patients with moderate-to-severe cognitive impairment. In recent years, observational assessment tools have been used when self-reported assessment tools were difficult to implement. However, no reports have investigated the usefulness of observational assessment tools in patients with acute-phase orthopedic disorders without comorbidities. This study examined the validity of observational tools for pain assessment in patients with lumbar vertebral fractures. Patients admitted to our hospital with acute-phase vertebral fractures were enrolled in this prospective study. Pain was assessed using Japanese versions of the Abbey Pain Scale and Doloplus-2 observational assessment tools, in addition to the Numerical Rating Scale, a self-reported assessment tool. To verify the validity of each pain assessment tool, we examined whether each tool correlated with the activities of daily living and ambulatory status. Activities of daily livings were assessed using the Barthel Index. Ambulatory status was assessed using the Functional Ambulation Categories and the 10-m walking test. Similar to the Numerical Rating Scale scores, assessments with the Abbey Pain Scale and Doloplus-2 showed significant decreases in scores over time. In addition, a significant positive correlation was observed between the self-reported and observational assessment tools. Each pain assessment tool was significantly negatively correlated with activities of daily livings and ambulatory status. Our results indicated when self-reported assessment with the Numerical Rating Scale was difficult for patients with cognitive impairment, pain could be estimated using the Abbey Pain Scale and Doloplus-2 observational assessment tools.

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