2025 ISAKOS Biennial Congress ePoster
Return to sports after unilateral medial opening wedge high tibial osteotomy in highly active patients -Analysis of factors affecting functional recovery-
Hiroshi Nakayama, MD., Ph.D., Nishinomiya, Hyogo JAPAN
Tomoya Iseki, MD, PhD, Nishinomiya, Hyogo JAPAN
Ryo Kanto, MD, Nishinomiya, Hyogo JAPAN
Shintaro Onishi, MD, PhD, Nishinomiya, Hyogo JAPAN
Shinichi Yoshiya, MD, Nishinomiya, Hyogo JAPAN
Toshiya Tachibana, MD, PhD, Nishinomiya, Hyogo JAPAN
Hyogo Medical University, Nishinomiya, Hyogo, JAPAN
FDA Status Not Applicable
Summary
return to sports after high tibial osteotomy
ePosters will be available shortly before Congress
Abstract
Purpose
The purpose of this study was to examine the outcomes following opening-wedge high tibial osteotomy (HTO) focusing on return to sports in a consecutive series of highly active patients who underwent a unilateral osteotomy procedure.
Methods
Sixty-three consecutive patients with preoperative Tegner’s activity score of 5 or more who underwent unilateral HTO for varus osteoarthritic knees were included in this study. The clinical results were evaluated using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the International Knee Documentation Committee (IKDC) Subjective Score. In radiological assessment, the following parameters were measured in full-length weightbearing radiographs both pre- and postoperatively; mechanical tibiofemoral angle (mTFA), mechanical medial proximal tibial angle (mMPTA), and joint-line convergence angle (JLCA). As regards postoperative functional recovery, inability to return to sports activities and reduction in the activity level on the Tegner scale were considered as failure to return to sports. Potential prognostic factors examined with logistic regression analysis were as follows: age ≥ 70, body mass index > 25, postoperative mTFA > 3° valgus or < 0° varus, postoperative mMPTA > 90°, opening gap > 10mm, and Kellgren-Laurence classification (KL) grade 4.
Results
At 2 years after surgery, the KOOS and the IKDC score improved from 231 to 437 and from 34 to 72, respectively with significant improvements in both scores. As for functional recovery, 50 patients (79.4%) could return to high-impact sports activities at the pre-symptomatic level with a mean time period of 8.0 months. Statistical analysis of the prognostic factors showed that postoperative mTFA > 3° valgus, opening gap > 10 mm and KL grade 4 were the factors significantly affecting the postoperative return to sports.
Conclusions
Presence of postoperative mTFA > 3° valgus, opening gap > 10mm and KL grade 4 were identified as risk factors impairing postoperative return to high-impact sports.