Abstract

Purpose

We hypothesized that patient treated with OWHTO who participate in high-impact sports would attain satisfactory outcome. The purpose of this study was to examine the clinical and radiological outcomes in a consecutive series of opening-wedge high tibial osteotomy (OWHTO) in highly active patients.

Methods

Seventy-seven consecutive patients who underwent OWHTO with varus osteoarthritic knees were included in the study. The mean age of the study population was 56.1 years. All patients were followed for a minimum of 2 years. Clinical and radiological evaluations were performed at 12 and 24 months after surgery. The clinical results were evaluated using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the International Knee Documentation Committee (IKDC) Subjective Score. In regards to radiological assessment, the following parameters were measured in full-length weightbearing radiographs both pre- and postoperatively; mechanical tibiofemoral angle (mTFA), mechanical lateral distal femoral angle (mLDFA), and weight bearing line (WBL) ratio.

Results

Fifty-eight patients (75.3%) returned to the same high-impact sports activities as before surgery, with a mean time to return of 8.7 ± 2.7 months (6–14 months). In the clinical assessments, the IKDC subjective score and KOOS both improved from the mean preoperative scores of 38.4 and 217.4 points to the mean postoperative scores of 74.5 and 421.6 points, respectively. The mean pre-symptomatic Tegner activity scale was 5.3 ± 0.6 and significantly decreased to 4.8 ± 1.2 at 2 years postoperative (p < 0.05). In the radiological evaluation, the postoperative mTFA, mMPTA, and WBL ratio values averaged 1.3° ± 2.2° valgus, 90.7° ± 2.9°, and 51.6% ± 8.4°, respectively, at 24 months after surgery.

Conclusions

Clinical outcomes based on postoperative patient-reported outcome measures and rate of return to high-impact sports activities were favorable after OWHTO in patients with knee OA who desired to continue sporting activities with the Tegner activity score of ≥ 5 points.

Level of evidence

Retrospective case series, IV.

中文翻译：

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运动员进行楔形高位胫骨截骨术后的运动恢复率

摘要

目的

我们假设参加OWHTO治疗并参加高影响运动的患者将获得令人满意的结果。这项研究的目的是检查高强度活动患者连续一系列的楔入式高位胫骨截骨术（OWHTO）的临床和放射学结果。

方法

该研究纳入了连续接受OWHTO内翻性膝关节炎的77例患者。研究人群的平均年龄为56.1岁。所有患者均接受了至少2年的随访。在手术后12和24个月进行临床和放射学评估。使用膝关节损伤和骨关节炎结果评分（KOOS）和国际膝关节文献委员会（IKDC）主观评分评估临床结果。关于放射学评估，在全长负重X线片术前和术后均测量了以下参数；胫骨机械角（mTFA），外侧股骨远端机械角（mLDFA）和负重线（WBL）的比率。

结果

58名患者（75.3％）恢复了与手术前相同的高影响力体育活动，平均恢复时间为8.7±2.7个月（6-14个月）。在临床评估中，IKDC主观评分和KOOS均从术前平均评分38.4和217.4分别提高到术后平均评分74.5和421.6。症状前的平均Tegner活动量表为5.3±0.6，术后2年显着下降至4.8±1.2（p  <0.05）。在放射学评估中，术后24个月，术后mTFA，mMPTA和WBL比值分别平均为1.3°±2.2°外翻，90.7°±2.9°和51.6％±8.4°。

结论

OWHTO后，希望继续进行Tegner活动评分≥5分的体育锻炼的膝OA患者，基于术后患者报告的结局指标和重返高强度体育活动的回报的临床结局是有利的。

证据水平

回顾性案例系列，IV。