Abstract
Objectives:
High tibial osteotomy (HTO) is usually performed in old patients with medial knee osteoarthritis(OA). However, little is known about the return to sport (RTS) and work (RTW) rates when performed in younger patients. Moreover, risk factors for RTS and the impact of kinesiophobia on RTS have been poorly investigated. The present study aimed to assess RTS and RTW rates, risk factors for RTS, complications, and activity levels at long-term follow-up in young and active patients after isolated HTO.
Methods:
Consecutive HTO procedures performed at a single institution with a 2-year minimum follow-up were screened. Data were collected regarding clinical scores, return to sport and work rates, type of sports, and level of sports impact. Multivariate regression analysis evaluated the impact of sex, age, BMI, Tegner, and TAMPA scale on RTS. Differences were considered statistically significant if p<0.05.
Results:
A total of 60 patients with a mean age at surgery of 28.9± 7.5 years were included at a mean follow-up of 8.8±3.8 years. There were 4 (6.7%) major complications. The overall return to sport rate was 86.7% and 68.3% of patients were still practicing sports at the final follow-up (mean 3.7±2.1 hours weekly). Additionally, 34.6% returned to the same sport level, 21.2% improved their status, and 44.2% decreased the sport level. Moreover, patients playing soccer had a lower percentage of return to sport when compared with the rest of the patients (72.7% vs 94.7%, p=0.04). The overall RTW rate was 100% at a mean of 5.9±6.2 months. Tampa scale was the only predictor of absolute return to sport (p=0.015, coefficient=0.13).
Conclusions:
HTO performed in a young and active population results in high return to sport rates and continuous sports participation even up to ten years after surgery. Interestingly, TAMPA scale was the only predictive factor for reduced RTS. Finally, soccer participation was associated with a lower RTS rate compared to other sports. Given high RTS and continuous sports participation, HTO could be considered as a potential surgical option for the management of young patients with symptomatic varus deformity.
