Can patients really participate in sport after high tibial osteotomy?

Bonnin, Michel; Laurent, Jean-Raphaël; Zadegan, Frédéric; Badet, R.; Archbold, H. A. P.; Servien, Elvire

doi:10.1007/s00167-011-1461-9

Cited by 99 publications

(84 citation statements)

References 39 publications

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“…Mancuso et al [59] found that only 30% of patients undergoing TKA expressed motivation to RTS, whereas Saragaglia et al [35] found that 71% of patients undergoing HTO were motivated to RTS but that neither the motivation nor the pre-existent sport level was related to greater RTS. In contrast, Bonnin et al [43] found a correlation between patient motivation and activity level, with motivated patients being more active postoperatively. These contrasting findings may be explained by the nature of the practiced sports.…”

Section: Discussionmentioning

confidence: 94%

“…The influence of patient motivation was mentioned in four studies. Bonnin et al [43] found motivation to be strongly correlated to RTS, whereas Saragaglia et al [35] found no correlation. The preoperative sports level was mentioned as a confounder in six studies.…”

Section: Resultsmentioning

confidence: 99%

“…Limited weight bearing for 6 weeksLysholm54.4 ± 18.976.2 ± 19.8 ( p < 0.01)Unknown% RTW: unknownTime to RTW: 94.5 ± 77.0 daysREFA 1: 68.1 ± 61.4 daysREFA 4: 155.0 ± 111.0 days( p = 0.023)Adjusted for in analysis: BMI (>35 not included); workload. Mentioned, not adjusted for: ageWorkload: REFA work (physical strain, n (%))0 (without)–111 (small)–92 (moderate)–53–4 (hard, most heavy)–14Definition of pre-op: unknownStudy: Bonnin et al [43], 2013, FranceDesign: ret, mc (four centers) cohort study; FU 4.2 ± 0.9 yearsPopulation: Pts with medial compartment OA and varus malalignment ( n = 139); age 59.1 (range 24–80); sex 98 M (71%), 41 F (29%); BMI 27.2 ± 4.1; Co: medical limitation (respiratory, cardiac or neurologic): 6LCW HTO ( n = 88)MOW HTO ( n = 51)Fixation: plate 114, blade plate + screws 18, staples 7NSSports participation, n (%)29 (20.8%) more active, 62 (44.6%) same activity level, 45 (33%) less active than before surgery. Time to RTS unknownUnknownAdjusted for in analysis: age; motivation.…”

Section: Methodsmentioning

confidence: 99%

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High Rates of Return to Sports Activities and Work After Osteotomies Around the Knee: A Systematic Review and Meta-Analysis

et al. 2017

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BackgroundKnee osteotomies are proven treatment options, especially in younger patients with unicompartmental knee osteoarthritis, for certain cases of chronic knee instability, or as concomitant treatment for meniscal repair or transplantation surgery. Presumably, these patients wish to stay active. Data on whether these patients return to sport (RTS) activities and return to work (RTW) are scarce.ObjectivesOur aim was to systematically review (1) the extent to which patients can RTS and RTW after knee osteotomy and (2) the time to RTS and RTW.MethodsWe systematically searched the MEDLINE and Embase databases. Two authors screened and extracted data, including patient demographics, surgical technique, pre- and postoperative sports and work activities, and confounding factors. Two authors assessed methodological quality. Data on pre- and postoperative participation in sports and work were pooled.ResultsWe included 26 studies, involving 1321 patients (69% male). Mean age varied between 27 and 62 years, and mean follow-up was 4.8 years. The overall risk of bias was low in seven studies, moderate in ten studies, and high in nine studies. RTS was reported in 18 studies and mean RTS was 85%. Reported RTS in studies with a low risk of bias was 82%. No studies reported time to RTS. RTW was reported in 14 studies; mean RTW was 85%. Reported RTW in studies with a low risk of bias was 80%. Time to RTW varied from 10 to 22 weeks. Lastly, only 15 studies adjusted for confounders.ConclusionEight out of ten patients returned to sport and work after knee osteotomy. No data were available on time to RTS. A trend toward performing lower-impact sports was observed. Time to RTW varied from 10 to 22 weeks, and almost all patients returned to the same or a higher workload.Electronic supplementary materialThe online version of this article (doi:10.1007/s40279-017-0726-y) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 94%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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High Rates of Return to Sports Activities and Work After Osteotomies Around the Knee: A Systematic Review and Meta-Analysis

et al. 2017

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“…However, the knee function expectations of that group are not very high [11] . In contrast, patients who are good candidates for a knee function preservation approach such as meniscal repair, meniscal transplantation, chondroplasty, or osteotomy [19] tend to have greater expectations to be able to continue impact sport, recreational or vocational activities. They also tend to be more willing and better able to implement significant behavioral changes, to develop the support systems needed for their maintenance, are willing to tolerate and live with minor-to-moderate intermittent knee pain and are willing to learn to become more pain tolerant.…”

Section: Introductionmentioning

confidence: 99%

Multi-factorial sustainability approach is necessary to preserve knee function following osteoarthritis diagnosis

Nyland

Jakob²

2013

WJO

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Knee function preservation following a diagnosis of osteoarthritis may benefit from healthy patient lifestyles, exercise or activity habits, and daily living routines. Underlying societal issues and social roles may contribute further to both ecological and knee function preservation concerns. Based on sustainability theory and social ecology concepts we propose that factors such as health history, genetic predisposition, socioenvironmental factors and local-regional-global physiological system viability contribute to knee function preservation. Addressing only some of these factors or any one factor in isolation can lead the treating physician, surgeon and rehabilitation clinician to less than optimal treatment effectiveness. An example is presented of a 57-year-old man with medial tibiofemoral osteoarthritis. In the intervention decision-making process several factors are important. Patients who would benefit from early knee arthroplasty tend to place osteoarthritic knee pain elimination at the top of their list of treatment expectations. They also have minimal or no desire to continue impact sport, recreational or vocational activities. In contrast, patients who are good candidates for a knee function preservation treatment 175October 18, 2013|Volume 4|Issue 4| WJO|www.wjgnet.com approach tend to have greater expectations to be able to continue impact sport, recreational or vocational activities, are willing and better able to implement significant behavioral changes and develop the support systems needed for their maintenance, are willing to tolerate and live with minor-to-moderate intermittent knee pain, and learn to become more pain tolerant. Key words: Knee surgery; Treatment planning; Comprehensive careCore tip: Total knee arthroplasty likely provides the best chance for knee osteoarthritic pain elimination. What is less understood by the patient is the needed reduction in recreational sport or vocational activities that will likely follow this intervention and the negative impact that elimination of these activities will potentially have on local-regional-global physiological systems, psychosocial factors, and quality of life. Patient satisfaction regarding the selection of either early knee arthroplasty or knee joint preservation is largely based on their expectations and the likelihood that these expectations are realistic.Nyland J, Jakob R. Multi-factorial sustainability approach is necessary to preserve knee function following osteoarthritis diagnosis. World

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“…However, the role of DFO and PTO in treating incipient unicompartmental osteoarthritis of the knee has been questioned, especially after the advent of unicompartmental knee replacement. Today, knee osteotomies are primarily used to treat incipient to moderate unicompartmental knee osteoarthritis in younger and active patients [15] who wish to resume high intensity sporting activities [4]. The popularity of knee osteotomies has fluctuated as changes in technique and results have been reported.…”

mentioning

confidence: 99%

CORR Insights®: Injury Risk to Extraosseous Knee Vasculature During Osteotomies: A Cadaveric Study With CT and Dissection Analysis

Solomon

2015

Clinical Orthopaedics &Amp; Related Research

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Can patients really participate in sport after high tibial osteotomy?

Abstract: Therapeutic study, Level IV.

Cited by 99 publications

References 39 publications

High Rates of Return to Sports Activities and Work After Osteotomies Around the Knee: A Systematic Review and Meta-Analysis

High Rates of Return to Sports Activities and Work After Osteotomies Around the Knee: A Systematic Review and Meta-Analysis

Multi-factorial sustainability approach is necessary to preserve knee function following osteoarthritis diagnosis

CORR Insights®: Injury Risk to Extraosseous Knee Vasculature During Osteotomies: A Cadaveric Study With CT and Dissection Analysis

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