Return to work and clinical outcome after open wedge HTO

Schröter, Steffen; Mueller, Johannes; Heerwaarden, Ronald van; Lobenhoffer, Philipp; Stöckle, Ulrich; Albrecht, Dirk

doi:10.1007/s00167-012-2129-9

Cited by 55 publications

(57 citation statements)

References 29 publications

(41 reference statements)

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“…One additional study reported that 89% of an homogeneous group of agricultural workers had returned to work after 8–12 months, but did not specify the exact timing [39]. Two studies found timing of RTW was significantly dependent on the workload, which was assessed using the REFA workload classification [25, 54]. Duration of inability to work varied from 6 and 10 weeks for REFA grade 0 (lowest workload) to 17 and 22 weeks for REFA 4 (heaviest physical strain) ( p < 0.05).…”

Section: Resultsmentioning

confidence: 99%

“…Finally, three studies adjusted for the effect of workload on RTW: two of these [25, 54] found that higher workloads resulted in longer inability to work, but one study [47] found no significant difference in RTW between high and low workloads. Only one study [34] compared RTW for different types of HTO; it found no significant difference in time to RTW between open- and closed-wedge HTO.…”

Section: Resultsmentioning

confidence: 99%

“…It seems reasonable that patients with physically demanding jobs need more time to RTW. Of the three studies we included that adjusted for workload, two found that higher workloads resulted in significantly longer inability to work [25, 54], but one study did not find this association [47]. Unfortunately, data on preoperative sick leave were not available for any of the included studies.…”

Section: Discussionmentioning

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: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

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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“…The REFA-Classification is already used in knee surgery to describe changes in the workplace after operative intervention [33]. However, it is a useful instrument that should also be established in the cruciate ligament surgery.…”

Section: Methodsmentioning

confidence: 99%

Occupational consequences after isolated reconstruction of the insufficient posterior cruciate ligament

Ihle

Ateschrang

Albrecht³

et al. 2014

BMC Res Notes

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BackgroundWith incorrect or even without treatment, acute injuries of the posterior cruciate ligament (PCL) can lead to chronic instability of the knee joint. After delayed treatment, negative occupational changes and reduced quality of life can occur. These aspects have not yet been investigated. The purpose of this study was to evaluate occupational consequences after isolated reconstruction in cases of chronic PCL insufficiency.Findings12 patients treated with PCL reconstruction in a single bundle technique, using hamstring tendon grafts, were evaluated. All patients were operated upon at least 3 months after injury. Mean time of follow-up was 51 ± 18.2 months (14–75). Radiological assessment (Telos stress device) showed a side comparison of total translation of 4.5 ± 2.6 mm. Occupational consequences have been evaluated by the classification system “REFA”. Median time incapacity for work was 8 weeks. Nearly all patients achieved the mental status of the normal population (SF-36), but physical status was still restricted. A pre- to postoperative improvement of the clinical scores could be seen: Lysholm-Score: 46.4 ± 17.3 to 84.7 ± 14.1, HSS-Score: 74.3 ± 10.5 to 88.3 ± 10.7. Postoperative evaluated scores were: Tegner score: 4.8 ± 1.2, IKDC score: 80.0 ± 16.2, VPS: 3.4 ± 2.7. Patients with low physical load in their workplace described significantly better clinical results in every clinical score (p < .05) and less pain than patients with high physical load prior to the accident (VPS: REFA < 2: 2.4 ± 2.6, REFA ≥ 2: 5.5 ± 1.7; p < 0.05).ConclusionsOperative treated patients with a chronic PCL insufficiency achieve an improvement of the clinical result. Patients with low physical load at their workplace achieve less restrictions.

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“…Unlike the KineSpring procedure, HTO involves significant bone removal and reshaping in an effort to shift loading from the diseased compartment to the unaffected compartment. The surgical invasiveness of HTO has been shown to require approximately 9 days of postoperative hospitalization, on average [19] as well as a substantial delay in return to work typically lasting 3 months with some patients incapacitated far longer [20]. Additionally, despite satisfactory early outcomes with HTO, patient outcomes reliably worsen over time [21].…”

Section: Discussionmentioning

confidence: 99%

Knee Osteoarthritis Treatment with the KineSpring Knee Implant System: A Report of Two Cases

Hayes

Miller

Block³

2012

Case Reports in Orthopedics

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Osteoarthritis (OA) is a leading cause of disability in middle-aged and older adults with the prevalence expected to increase by 40% by 2025. This dramatic projected increase in OA reflects, in large part, the alarming obesity epidemic. Indeed, it is now well understood that abnormal loading across the knee joint due to malalignment and/or excessive weight gain is responsible for accelerating OA progression. Consequently, there is a therapeutic need for alternative knee OA treatments that directly address joint overload to fill the gap between ineffective conservative care and invasive joint-modifying surgical procedures. We describe two cases that presented with bilateral knee OA resistant to conservative treatments, each with one knee previously and unsuccessfully treated with high tibial osteotomy to improve alignment and the contralateral knee successfully treated with a joint-preserving, load-absorbing implant (KineSpring Knee Implant System).

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Return to work and clinical outcome after open wedge HTO

Abstract: IV.

Cited by 55 publications

References 29 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

Occupational consequences after isolated reconstruction of the insufficient posterior cruciate ligament

Knee Osteoarthritis Treatment with the KineSpring Knee Implant System: A Report of Two Cases

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