Assessment of return to sport and functional outcomes following distal femoral, double level and high tibial osteotomies for active patients with symptomatic varus malalignment

Abstract

Purpose This study indicated the outcomes of three surgical techniques for the treatment of symptomatic unicompartmental knee osteoarthritis (UKOA) with varus malalignment in younger, active patients: distal femoral osteotomy (DFO), doublelevel osteotomy (DLO) and high tibial osteotomy (HTO). The outcomes measured included the return to sport, sport activity and functional scores. Methods A total of 103 patients (19 DFO, 43 DLO, 41 HTO) were enrolled in the study and were divided into three groups based on their oriented deformity, each undergoing one of the three surgical techniques. All patients underwent pre-and post-operative evaluations including X-rays, physical exams and functional assessments. Results All three surgical techniques were efective in treating UKOA with constitutional malalignment. The average time to return to sport was similar among the three groups (DFO: 6.4 ± 0.3 [5.8-7] months, DLO: 4.9 ± 0.2 [4.5-5.3] months, HTO: 5.6 ± 0.2 [5.2-6] months). The sport activity and functional scores improved signiicantly for all three groups, with no signiicant diferences observed among the groups. Conclusion Various knee osteotomy procedures, DFO, DLO, and HTO, result in high RTS rates and quick RTS times with satisfactory functional scores. Despite pre-to post-operative improvements in sport activities following DFO and DLO, pre-symptom levels were not reached following all evaluated procedures. Level of evidence Retrospective case-control study, Level III.

Better clinical outcomes and return to sport rates with additional medial meniscus root tear repair in high tibial osteotomy for medial compartmental knee osteoarthritis

“…Minzlaf et al [31] reported that young active patients were able to return to the preoperative sports activity level 1 year after undergoing osteochondral autologous transplantation with OWHTO for valgus defect. More recent studies have shown similar findings, including 87%-94% of patients returning to sports and work, with 78%-85% returning to their presymptomatic sports level after knee osteotomies [1,19,26]. However, the rate of return to sports after MMPRT repair in patients who underwent OWHTO has not been reported.…”

Superior accuracy in knee double level osteotomy using a novel hybrid fixation technique compared to conventional double plating

“…However, in cases of substantial or bifocal deformities, a single‐level osteotomy may significantly increase the joint line obliquity (JLO) with resultant tibiofemoral subluxation, pressure distribution changes and excessive shear stresses on the articular cartilage [ 2 , 34 , 37 , 54 ]. In such cases, DLO is gaining popularity over single‐level knee osteotomy due to its merits in maintaining a more physiologic joint alignment and orientation with better clinical results [ 1 , 7 , 47 ] and comparable return to sports [ 6 , 12 ]. Nevertheless, DLO is a complex procedure, and accuracy is of the essence.…”