Return to sports activity after opening wedge high tibial osteotomy in patients aged 70\xa0years and older

Akio Otoshi,Kazuma Miyatake,Yutaka Inaba,Shuntaro Nejima,Ken Kumagai,Takahiro Fujisawa,Shunsuke Yamada

doi:10.1186/s13018-021-02718-6

Akio Otoshi, Kazuma Miyatake + Show 5 more

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https://doi.org/10.1186/s13018-021-02718-6

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Abstract

BackgroundThe purpose of this study was to evaluate return to sports (RTS) after opening wedge high tibial osteotomy (OWHTO) in elderly patients and associated factors affecting RTS.MethodsSeventy-four patients (mean age 68 years) who underwent OWHTO were enrolled. Clinical outcomes were evaluated using the Knee Society Score (KSS). Patients were asked regarding types of sports activities and their levels of participation within preoperative 1 year and postoperative 1 year. Levels of participation in sports and recreational activities were examined using the Tegner activity scale. The outcomes were compared between two age groups (≥ 70 years vs. < 70 years).ResultsOf the 74 patients overall, 59 participated in at least one sport preoperatively, and 55 returned to sports postoperatively (RTS 93%). The KSS knee score and function score were significantly improved after surgery in both age groups (P < 0.05), but no significant differences were found between the age groups. The Tegner activity scales for ≥ 70 years and < 70 years were 2.9 ± 1.1 and 4.0 ± 1.9 preoperatively (P < 0.01) and 2.7 ± 1.2 and 3.3 ± 1.4 postoperatively (P = 0.16), respectively. RTS was reported by 24 of 25 (96.0%) in the age < 70 years group and 31 of 34 (91.2%) in the age ≥ 70 years group. Majority of age ≥ 70 years participated in low-impact sports preoperatively and returned to the same impact level postoperatively.ConclusionsThe rate of RTS after OWHTO was high in patients aged 70 years and older with low-impact level. OWHTO is a preferred surgical option for elderly patients who desire RTS.

Highlights

Osteoarthritis (OA) of the knee is a common disease in the aged population and the leading cause of restriction of activities of daily living (ADL)
The Knee Society Score (KSS) knee score and function score were significantly improved after surgery overall and in both age groups (P < 0.05), but no significant differences were found between the ≥ 70 years and < 70 years groups
Standing femorotibial angle (FTA) and %Percentage of mechanical axis deviation (MAD) were significantly changed after surgery in both age groups (P < 0.05), but there were no significant differences between the two age groups

Summary

Introduction

Osteoarthritis (OA) of the knee is a common disease in the aged population and the leading cause of restriction of activities of daily living (ADL). Since most countries have rising life expectancy and an aging population, extension of healthy life expectancy is a critical issue, and. High tibial osteotomy (HTO) is an established treatment option for OA of the knee. Proper overcorrection provides pain relief and subsequent improvement of knee function [1, 2]. The opening wedge HTO (OWHTO) has recently become commonly used, and good mid-term to long-term clinical outcomes have been demonstrated in patients over 70 years of age [3]. The purpose of this study was to evaluate return to sports (RTS) after opening wedge high tibial osteotomy (OWHTO) in elderly patients and associated factors affecting RTS

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