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

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

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), double-level 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 effective 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 significantly for all three groups, with no significant differences 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.

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Data availability

Data available upon request.

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Funding

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Author information

Authors and Affiliations

  1. Tokyo Medical and Dental University, Tokyo, Japan

    Jae-Sung An & Hideyuki Koga

  2. Leeds Teaching Hospitals, Leeds, UK

    Ahmed Mabrouk

  3. Institut du Mouvement et de l’appareil locomoteur, Hôpital Sainte-Marguerite, Aix-Marseille Université, 270, Boulevard Sainte-Marguerite, 13009, Marseille, France

    Jae-Sung An, Ahmed Mabrouk, Raghbir Khakha, Kristian Kley, Christophe Jacquet & Matthieu Ollivier

  4. Guys and St. Thomas’ Hospitals, Great Maze Pond, London, UK

    Raghbir Khakha

  5. Harley Street Specialist Hospital, 18-22, Queen Anne Street, London, W1G8HU, UK

    Kristian Kley

  6. Orthopädie Maximilium, Donauwörth, Germany

    Kristian Kley

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  1. Jae-Sung An
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Contributions

MO, KK design the study protocol. MO operated all patients of the series. JA, AM wrote the initial manuscript. HK, CJ edited the manuscript. JA, CJ performed statistical analysis. AM, RK performed english editing (native english speakers).

Corresponding author

Correspondence to Matthieu Ollivier.

Ethics declarations

Conflict of interest

MO, KK, RK consultant for newclip technique.

Ethical approval

“Non interventional research”: waiver from the French national ethic regulation.

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Acquired for all patients.

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An, JS., Mabrouk, A., Khakha, R. et al. Assessment of return to sport and functional outcomes following distal femoral, double level and high tibial osteotomies for active patients with symptomatic varus malalignment. Knee Surg Sports Traumatol Arthrosc 31, 4285–4291 (2023). https://doi.org/10.1007/s00167-023-07457-1

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