High Rates of Return to Sports Activities and Work After Osteotomies Around the Knee: A Systematic Review and Meta-Analysis
The aim of this article was to evaluate the resumption of physical activity and sports after valgus osteotomy for medial femorotibial osteoarthritis. This series is composed of 83 patients, with 27 females and 56 males. The mean age was 50.4 ± 9.53 years (32–67) at the time of operation. Before the onset of symptoms of knee osteoarthritis, four (4.8 %) patients practiced a competitive sport, 44 (53 %) one (or more) recreational sport on a regular basis, 17 (20 %) occasionally and 18 (21.6 %) did not practice any sport but were active. Sixty-two opening wedge high tibial osteotomies were performed as well as 21 double level osteotomies for severe deformity. All the osteotomies were computer-assisted in order to reach the best overcorrection. At a mean follow up of 5.75 ± 1.3 years (five to nine years), 71 patients (85.5 %) resumed sporting activities and 66 (79.5 %) felt they had found a sporting level equal to the level prior surgery. The mean Lysholm score increased from 62.51 ± 15.53 points (30-100) pre-operatively to 90.49 ± 8.62 points (55–100) postoperatively (p < 0.001). The Tegner and UCLA scores didn’t decrease significantly after surgery (4.53 and 7.14 pre-operatively versus 4.1 and 6.55 postoperatively, p = 0.07 and 0.09). The mean postoperative KOO score was 73.52 ± 17.20. The frequency of sports sessions per week (2.36 ± 1.6) did not decrease significantly after surgery (2.13 sessions, p = 0.34). On the other hand, the duration of activities decreased significantly from 4.68 hours/week ± 4.25 to 3.48 hours/week (p = 0.04). Of the patients who practiced running before surgery 85 % (17 of 20) were able to resume this activity. This study demonstrates that knee osteotomies for medial femorotibial osteoarthritis allow the resumption of sustained physical activity such as jogging or skiing downhill in a majority of patients.