Introduction

A double level osteotomy (DLO) may be indicated in patients with genu varum when the deformity involves both the tibia and femur. These patients, who are often young and active, have a high functional demand and hope for a rapid return to sport. The purpose of our study was to assess return to sport and functional outcomes following DLO for symptomatic genu varum.

Materials and methods

A total of 40 patients (mean age 45.5 ± 2 years) who underwent a DLO between 2018 and 2020, performed in 2 different hospitals, were reviewed after a minimum follow-up of 1-year. The mean initial varus was 11 ± 2°. The type of sport and frequency of participation (UCLA activity score) as well as time to return to sport and level of activity recovered were defined as the primary endpoints. Functional scores were also assessed with the knee injury and osteoarthritis outcome score (KOOS).

Results

At the last follow-up, 87.5% (n = 35) of patients reported that they had returned to sport. The mean time to return to sport was 6 ± 1 months with a significant difference (p < 0.001) between the pre- and postoperative UCLA activity scores. There was a strong correlation between the presence of a joint line obliquity >3° and decreased functional outcomes (p < 0.0001). The overall KOOS score improved (p < 0.001) by a mean of 38.6 points after the correction. The 8 lateral cortical fractures (Takeuchi type I and II) and the 2 medial cortical fractures (Nakayama type 1) that were found had no impact on functional outcomes (p > 0.05).

Conclusion

Our findings demonstrated that DLO provided rapid return to sport, thus making it possible to meet the functional demands and expectations of patients.

Level of evidence

IV; Retrospective study.

中文翻译：

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膝内翻的双节段截骨术：是否有可能重返运动？

介绍

当畸形涉及胫骨和股骨时，双节段截骨术(DLO) 可能适用于膝内翻患者。这些患者通常年轻且活跃，对功能有很高的要求，希望能够迅速恢复运动。我们研究的目的是评估症状性膝内翻的 DLO 后恢复运动和功能结果。

材料和方法

共有 40 名患者（平均年龄 45.5  ±  2 岁）在 2018 年至 2020 年期间在 2 家不同的医院接受了 DLO，在至少 1 年的随访后进行了审查。平均初始内翻为 11  ± 2°。运动类型和参与频率（UCLA 活动评分）以及恢复运动的时间和恢复的活动水平被定义为主要终点。还通过膝关节损伤和骨关节炎结果评分 (KOOS) 评估了功能评分。 

结果

在最后一次随访时，87.5% ( n  =  35) 的患者报告说他们已恢复运动。恢复运动的平均时间为 6  ± 1 个月，术前和术后 UCLA 活动评分之间 存在显着差异 ( p  < 0.001)。 关节线倾斜 >3° 与功能结果下降之间存在很强的相关性 ( p  <  0.0001)。整体 KOOS 评分在校正后平均提高了 ( p  < 0.001) 38.6 分。 发现的 8 例外侧皮质骨折（Takeuchi I 型和 II 型）和 2 例内侧皮质骨折（Nakayama 1 型）对功能结果没有影响 ( p  >  0.05)。

结论

我们的研究结果表明，DLO 可以快速恢复运动，从而有可能满足患者的功能需求和期望。

证据等级

四；回顾性研究。