Advertisement

Can patients really participate in sport after high tibial osteotomy?

  • Michel P. BonninEmail author
  • Jean-Raphael Laurent
  • Frédéric Zadegan
  • Roger Badet
  • H. A. Pooler Archbold
  • Elvire Servien
Knee

Abstract

Purpose

The possibility to return to sporting activity can be an important consideration in the decision-making process in femorotibial osteoarthritis. We analyzed functional outcomes and sport participation in a continuous series of HTO and asked whether this procedure could match expectations in active and motivated patients.

Methods

We retrospectively investigated activities, sports participation, and the level of satisfaction in 139 patients with unilateral noncomplicated HTO. The study included 41 women and 98 men with a mean age of 59 years and a mean 50 months of follow-up.

Results

Eighty-seven patients (63%) reported that their knee was “normal,” and eighty-six patients (62%) felt that their activities were limited by their knee. A total of 78 patients (56%) reported that they were as active as they expected to be before the intervention. Of these patients, 98% were satisfied. Of the patients who were not as active as they thought they would be, 51% were satisfied (P < 0.0001). The duration of preoperative pain, the age at evaluation, and the number of previous surgeries did not influence the subjective result. Among patients under 75 years, 28% regularly participated in strenuous sports, but 40% were motivated for these activities. 66% of the motivated patients regularly participated in at least one impact sport.

Conclusion

This study shows that young motivated patients are able to resume strenuous activities following HTO. However, patients must be informed that they will typically not recover their pre-pathology level and that residual pain during strenuous sports is not exceptional.

Level of evidence

Therapeutic study, Level IV.

Keywords

Knee Osteoarthritis Osteotomy Sport Function 

Notes

Acknowledgments

The authors thank the other participating orthopedic surgeons who included their patients in this series: P. Chambat (Lyon France), P. Neyret (Lyon France), P Beaufils (Versailles, France). The authors thank Nadine Bossard MD for the department of biostatistics: Hospices Civils de Lyon, Université Lyon I, Villeurbanne, 69622, France; CNRS; UMR 5558, Laboratoire Biostatistique Santé, Pierre-Bénite, 69495, France. Authors thank ESSKA for its financial support for this study.

Supplementary material

167_2011_1461_MOESM1_ESM.doc (104 kb)
Supplementary material 1 (DOC 103 kb)

References

  1. 1.
    Ahlback S (1968) Osteoarthrosis of the knee. A radiographic investigation. Acta Radiol Diagn (Stockh) 7:72 (Suppl 277)Google Scholar
  2. 2.
    Akizuki S, Shibakawa A, Takizawa T, Yamazaki I, Horiuchi H (2008) The long-term outcome of high tibial osteotomy: a 10- to 20-year follow-up. J Bone Joint Surg Br 90:592–596PubMedCrossRefGoogle Scholar
  3. 3.
    Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt L (1988) Validation study of WOMAC: a health status instrument for measuring clinically-important patient- relevant outcomes following total hip or knee arthroplasty in osteoarthritis. J Rheumatol 15:1833–1840PubMedGoogle Scholar
  4. 4.
    Berman AT, Bosacco SJ, Kirshner S, Avolio A Jr (1991) Factors influencing long term results in HTO. Clin Orthop Relat Res 272:192–198PubMedGoogle Scholar
  5. 5.
    Billings A, Scott DF, Camargo MP, Hofman AA (2000) High tibial osteotomy with a calibrated osteotomy guide, rigid internal fixation and early motion. Long term follow up. J Bone Joint Surg Am 82:70–79PubMedGoogle Scholar
  6. 6.
    Bonnin M, Laurent JR, Parratte S, Zadegan F, Badet R, Bissery A (2010) Can patients really do sport after TKA? Knee Surg Sports Traumatol Arthrosc 18:853–862PubMedCrossRefGoogle Scholar
  7. 7.
    Bonnin Chambat (2004) Current status of valgus angle, tibial head closing wedge osteotomy in media gonarthrosis. Orthopäde 33:135–142PubMedCrossRefGoogle Scholar
  8. 8.
    Bouharras M, Hoet F, Watillon M, Despontin J, Geulette R, Thomas P, Parmentier D (1994) Devenir des OTV pour AFTI avec un recul de plus de 8 ans. Acta Orthop Belgica 60:163–169Google Scholar
  9. 9.
    Bradbury N, Borton D, Spoo G, Cross MJ (1998) Participation in sports after total knee replacement. Am J Sports Med 26:530–535PubMedGoogle Scholar
  10. 10.
    Chatterji U, Ashworth MJ, Lewis PL, Dobson PJ (2005) Effect of total knee arthroplasty on recreational and sporting activity. ANZ J Surg 75:405–408PubMedCrossRefGoogle Scholar
  11. 11.
    Coventry MB, Ilstrup DM, Wallrichs SL (1993) Proximal tibial osteotomy. A critical long term study of eighty-seven cases. J Bone Joint Surg Am 75:196–201PubMedGoogle Scholar
  12. 12.
    Dahm DL, Barnes SA, Harrington JR, Sayeed SA, Berry DJ (2008) Patients reported activity level after total knee arthroplasty. J Arthroplasty 23:401–407PubMedCrossRefGoogle Scholar
  13. 13.
    Diduch DR, Insall JN, Scott WN, Scuderi GR, Font-Rodriguez D (1997) Total knee replacement in young active patients. Long-term follow-up and functional outcome. J Bone Joint Surg Am 79:575–582PubMedGoogle Scholar
  14. 14.
    Felts E, Parratte S, Pauly V, Aubaniac JM, Argenson JN (2010) Function and quality of life following medial unicompartmental knee arthroplasty in patients 60 years of age or younger. Orthop Traumatol Surg Res. PMID: 21087906Google Scholar
  15. 15.
    Fisher N, Agarwal M, Reuben SF, Johnson DS, Turner PG (2006) Sporting and physical activity following Oxford medial unicompartmental knee arthroplasty. Knee 13:296–300PubMedCrossRefGoogle Scholar
  16. 16.
    Flecher X, Parratte S, Aubaniac JM, Argenson JN (2006) A 12–28-year followup study of closing wedge high tibial osteotomy. Clin Orthop Relat Res 452:91–96PubMedCrossRefGoogle Scholar
  17. 17.
    Healy WL, Sharma S, Schwartz B, Iorio R (2008) Athletic activity after total joint arthroplasty. J Bone Joint Surg Am 90:2245–2252PubMedCrossRefGoogle Scholar
  18. 18.
    Hernigou P, Medevielle D, Debeyre J, Goutallier D (1987) Proximal tibial osteotomy for osteoarthritis with varus deformity. J Bone Joint Surg Am 69:332–354PubMedGoogle Scholar
  19. 19.
    Holden DL, James SL, Larson RL, Slocum DB (1988) Proximal tibial osteotomy in patients who are 50 years old or less. J Bone Joint Surg Am 70:977–982PubMedGoogle Scholar
  20. 20.
    Hopper GP, Leach WJ (2008) Participation in sporting activities following knee replacement: total versus unicompartmental. Knee Surg Sports Traumatol Arthrosc 16:973–979PubMedCrossRefGoogle Scholar
  21. 21.
    Ivarsson I, Myrnerts R, Gillquist J (1990) HTO for medial osteoarthritis of the knee. A 5 to 7 and 11 year follow-up. J Bone Joint Surg Br 72:238–244PubMedGoogle Scholar
  22. 22.
    Korovessis P, Katsoudas G, Salonikides P, Stamatakis M, Baikousis A (1999) Medium- and long-term results of high tibial osteotomy for varus gonarthrosis in an agricultural population. Orthopedics 22:729–736PubMedGoogle Scholar
  23. 23.
    Lavernia CJ, Sierra RJ, Hungerford DS, Krackow K (2001) Activity Level and wear in total knee arthroplasty: a study of autopsy retrieved specimens. J Arthroplasty 16:446–453PubMedCrossRefGoogle Scholar
  24. 24.
    Lootvoet L, Massinon A, Rossillon R, Himmer O, Lambert K (1993) Ostéotomie tibiale haute de valgisation pour gonarthrose sur genu varum. A propos d’une série de 193 cas revus après 6 à 10 ans de recul. Rev Chir Orthop Reparatrice Appar Mot 79:375–384PubMedGoogle Scholar
  25. 25.
    Majima T, Yasuda K, Katsuragi R, Kaneda K (2000) Progression of joint arthrosis 10 to 15 years after HTO. Clin Orthop Relat Res 381:177–184PubMedCrossRefGoogle Scholar
  26. 26.
    Mallon WJ, Callaghan JJ (1993) Total knee arthroplasty in active golfers. J Arthroplasty 8:299–306PubMedCrossRefGoogle Scholar
  27. 27.
    Mancuso CA, Sculco TP, Wickiewicz TL, Jones EC, Robbins L, Warren RF, Williams-Russo P (2001) Patient’s expectations of knee surgery. J Bone Joint Surg Am 83:1005–1012PubMedCrossRefGoogle Scholar
  28. 28.
    Matthews LS, Goldstein SA, Malvitz TA, Katz BP, Kaufer H (1988) Proximal tibial osteotomy factors that influence the duration of satisfactory function. Clin Orthop Relat Res 229:193–200PubMedGoogle Scholar
  29. 29.
    Mont MA, Rajadhyaksha AD, Marxen JL, Silberstein CE, Hungerford DS (2002) Tennis after total knee arthroplasty. Am J Sports Med 30:163–166PubMedGoogle Scholar
  30. 30.
    Naal FD, Fischer M, Preuss A, Goldhahn J, von Knoch F, Preiss S, Munzinger U, Drobny T (2007) Return to sports and recreational activity after unicompartmental knee arthroplasty. Am J Sports Med 35:1688–1695PubMedCrossRefGoogle Scholar
  31. 31.
    Nagel A, Insall JN, Scuderi GR (1996) Proximal tibial osteotomy: a subjective outcome study. J Bone Joint Surg Am 78:1353–1358PubMedGoogle Scholar
  32. 32.
    Naudie D, Bourne RB, Rorabeck CH, Bourne TJ (1999) Survivorship of the high tibial valgus osteotomy. Clin Orthop Relat Res 367:18–27PubMedCrossRefGoogle Scholar
  33. 33.
    Noble PC, Gordon MJ, Weiss JM, Reddix RN, Conditt MA, Mathis KB (2005) Does total knee replacement restore normal knee function? Clin Orthop Relat Res 431:157–165PubMedCrossRefGoogle Scholar
  34. 34.
    Noble PC, Conditt MA, Cook KF, Mathis KB (2006) Patients expectations affect satisfaction with total knee arthroplasty. Clin Orthop Relat Res 452:35–43PubMedCrossRefGoogle Scholar
  35. 35.
    Odenbring S, Tjörnstrand B, Egund N, Hagstedt B, Hovelius L, Lindstrand A, Luxhöj T, Svanström A (1989) Function after Osteotomy for medial gonarthrosis below aged 50 years. Acta Orthop Scand 60:527–531PubMedCrossRefGoogle Scholar
  36. 36.
    Rinonapoli E, Mancini GB, Corvaglia A, Musiello S (1998) Tibial osteotomy for varus gonarthrosis. Clin Orthop Relat Res 353:185–193PubMedCrossRefGoogle Scholar
  37. 37.
    Rudan JF, Simurda MA (1991) Valgus tibial osteotomy a long term follow up study. Clin Orthop Relat Res 268:157–160PubMedGoogle Scholar
  38. 38.
    Salzmann GM, Ahrens P, Naal FD, El-Azab H, Spang JT, Imhoff AB, Lorenz S (2009) Sporting activity after high tibial osteotomy for the treatment of medial compartment knee osteoarthritis. Am J Sports Med 37:312–318PubMedCrossRefGoogle Scholar
  39. 39.
    Schmalzried TP, Shepherd EF, Dorey FJ, Jackson WO, dela Rosa M, Favae F, McKellop HA, McClung CD, Martell J, Moreland JR, Amstutz HC (2000) Wear is a function of use, not time. Clin Orthop Relat Res 381:36–46PubMedCrossRefGoogle Scholar
  40. 40.
    Ware JE, Kosinski M, Turner-Bowker DM, Gandeck B (2007) QualiMetric user’s manual for the SF-12v2™ Health Survey, QualiMetric Incorporated, Lincoln USA. ISBN: 1-891810-10-3Google Scholar
  41. 41.
    Weiss JM, Noble PC, Conditt MA, Kohl HW, Roberts S, Cook KF, Gordon MJ, Mathis KB (2002) What functional activities are important to patients with knee replacements? Clin Orthop Relat Res 404:172–188PubMedCrossRefGoogle Scholar
  42. 42.
    Yasuda K, Majima T, Tsuchida T, Kaneda K (1992) A ten- to 15 -years follow up observation of HTO in medial compartment OA. Clin Orthop Relat Res 282:186–195PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Michel P. Bonnin
    • 1
    Email author
  • Jean-Raphael Laurent
    • 1
  • Frédéric Zadegan
    • 2
  • Roger Badet
    • 3
  • H. A. Pooler Archbold
    • 1
  • Elvire Servien
    • 4
  1. 1.Centre Orthopédique SantyLyonFrance
  2. 2.Centre Hospitalier de VersaillesLe ChesnayFrance
  3. 3.Clinique Saint Vincent de PaulBourgoin JallieuFrance
  4. 4.Centre Albert Trillat—Hôpital de la Croix-Rousse, Hospices Civils de LyonLyon-CaluireFrance

Personalised recommendations