Abstract
Background: Distal femoral varus osteotomy (DFVO) is an effective surgical intervention for the management of symptomatic valgus malalignment of the knee. Because it preserves the native knee joint and its ligamentous stability, DFVO is preferred to total knee arthroplasty (TKA) in the young, active population. Purpose: We sought to assess return to work (RTW) and return to sport (RTS) rates following DFVO for valgus malalignment of the knee. Methods: For this systematic review, we searched EMBASE, MEDLINE, and Web of Science from inception through December 31, 2020. English language studies of all levels of evidence explicitly reporting on RTS and RTW rates following DFVO for valgus malalignment of the knee were eligible for inclusion. Results: Seven studies and 127 patients were included in our analysis. Mean age was 32.4 ± 8.8 years with men comprising 46.7% ± 22.3% of study populations. The mean RTS rate was 87.2% ± 10.7%, with a return to preoperative activity levels rate of 65.4% ± 26.8%. The mean RTW rate was 81.8% ± 23.3%, with a return to preoperative activity levels of 72.8% ± 18.1%. The mean reoperation rate was 35.6% ± 18.8% within a mean follow-up period of 5.5 ± 1.9 years. Conclusions: This systematic review of low-level studies found DFVO to be a safe and effective procedure for the management of genu valgum in young, active populations, with most patients returning to sport and/or work, although not all at their preoperative activity levels. A paucity of data surrounds RTS and RTW rates following DFVO. Future studies should explicitly report both return to activity rates and whether patients returned to their preoperative activity levels.
Highlights
In the United States, the prevalence of osteoarthritis (OA) has nearly doubled over several decades and affects more than 32.5 million adults [38,53]
A systematic search of 3 electronic databases—the Excerpta Medica Database (EMBASE), the Medical Literature Analysis and Retrieval System Online (MEDLINE), and Web of Science—was performed by 2 reviewers for literature related to Distal femoral varus osteotomy (DFVO) for the valgus knee
1 of the studies included in this analysis reported both return to sport (RTS) and return to work (RTW) rates [11]
Summary
In the United States, the prevalence of osteoarthritis (OA) has nearly doubled over several decades and affects more than 32.5 million adults [38,53]. Knee OA with valgus alignment beyond the physiological 5° to 8° can lead to altered load bearing within the knee joint, which results in increased loading of the lateral compartment [7,17] Over time, this can progress to chondral and meniscal damage, worsening valgus deformity, and, worsening of OA [15,17]. English language studies of all levels of evidence explicitly reporting on RTS and RTW rates following DFVO for valgus malalignment of the knee were eligible for inclusion. Conclusions: This systematic review of low-level studies found DFVO to be a safe and effective procedure for the management of genu valgum in young, active populations, with most patients returning to sport and/or work, not all at their preoperative activity levels. Future studies should explicitly report both return to activity rates and whether patients returned to their preoperative activity levels
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