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      Return to Sports After High Tibial Osteotomy Using the Opening Wedge Technique *

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          Abstract

          Objective  The present paper evaluates the resuming of physical activities by young, active patients who practiced some sport modality and underwent a high tibial osteotomy (HTO) using the opening wedge technique.

          Methods  A total of 12 patients submitted to HTO using the opening wedge technique were prospectively analyzed. All patients were not playing sports at that time. Pre- and postoperative Lysholm and International Knee Documentation Committee (IKDC) scores, visual analog scale for pain and performance level were compared. The average follow-up time was of 12 months.

          Results  One patient resumed sporting activities at a performance level significantly lower compared to the preoperative level, while eight patients returned at a slightly below level, two returned at the same level and one patient returned at a higher level in comparison with the preoperative period.

          Conclusion  For isolated medial osteoarthrosis treatment, HTO using the opening wedge technique has favorable clinical and functional results, allowing patients to resume their sporting activities.

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          Most cited references32

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          Proximal tibial osteotomy for osteoarthritis with varus deformity. A ten to thirteen-year follow-up study.

          D Medevielle, D Goutallier, J Debeyre … (1987)
          The results in ninety-three knees that had been treated by proximal tibial opening-wedge osteotomy for varus deformity and osteoarthritis of the medial compartment were evaluated after a mean length of follow-up of 11.5 years (range, ten to thirteen years). After ten years, only forty-two (45 per cent) of the ninety-three knees had an excellent or good result, and in fifty-one knees there was recurrent pain for which seventeen had another operation. At five years, on the other hand, 90 per cent of the knees had a good result. Deterioration occurred at an average of seven years after the osteotomy and was always associated with recurrence of pain. Although the results deteriorated with time, time was not the only determinant of the result. Alignment, measured as the hip-knee-ankle angle on radiographs of the whole limb that were made with the patient bearing weight, was also a determinant of long-term results. The best results were obtained in the twenty knees that had a hip-knee-ankle angle of 183 to 186 degrees. In these knees, there was no pain and no progression of the arthrosis in either the medial or the lateral tibiofemoral compartment. Of the five knees that had an angle of more than 186 degrees, all five had progressive degenerative changes in the lateral compartment. In the sixty-eight undercorrected knees (an angle of less than 183 degrees), the results were less satisfactory, and there was a tendency toward recurrence of the varus deformity and progression of the arthritis of the medial compartment. However, when the correction was insufficient the deterioration was slow (average, seven years), and it was not associated with lateral laxity and deterioration of the lateral compartment, which are the changes that characterize the natural course of gonarthrosis as described by Hernborg and Nilsson. Therefore, proximal tibial osteotomy is a very suitable operation for patients who have gonarthrosis of the medial compartment, but a rigidly standardized and precise operative technique is required as well as accurate radiographic measurements of the mechanical axis of the limb, because exact postoperative alignment is the prerequisite for the longest possible period of relief of symptoms after osteotomy.
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            Athletic activity after total joint arthroplasty.

            Laura Healy, Sanjeev Sharma, Richard Iorio … (2008)
            Demand for total joint arthroplasty is projected to increase in the first three decades of the twenty-first century. With increasing frequency, patients who have a hip or knee replacement expect to, and choose to, participate in athletics following rehabilitation. In general, patients who have had a hip or knee replacement decrease their participation in, and intensity of, athletic activity following the total joint arthroplasty. The orthopaedic literature on athletic activity after total joint arthroplasty is limited to small retrospective studies with short-term follow-up. Expert opinion regarding appropriate athletic activity after total joint arthroplasty is available from the Hip Society and the Knee Society. When patients who have undergone joint replacements choose to participate in athletic activity, orthopaedic surgeons should provide information with which to evaluate the risk of sports activity and recommend appropriate athletic activity.
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              Preoperative Planning for High Tibial Osteotomy : The Effect of Lateral Tibiofemoral Separation and Tibiofemoral Length

              THOMAS W. DUGDALE, FRANK R. NOYES, DAVID STYER (1992)
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                Author and article information

                Journal
                Journal ID (nlm-ta): Rev Bras Ortop (Sao Paulo)
                Journal ID (iso-abbrev): Rev Bras Ortop (Sao Paulo)
                Journal ID (doi): 10.1055/s-00042410
                Title: Revista Brasileira de Ortopedia
                Publisher: Thieme Revinter Publicações Ltda. (Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil )
                ISSN (Print): 0102-3616
                ISSN (Electronic): 1982-4378
                Publication date (Print): June 2021
                Publication date (Electronic): 25 September 2020
                Volume: 56
                Issue: 3
                Pages: 313-319
                Affiliations
                [1 ]Centro de Traumatologia do Esporte, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
                [2 ]Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
                [3 ]Departamento de Ortopedia e Traumatologia, Instituto de Assistência Médica ao Servidor Público Estadual de São Paulo, São Paulo, SP, Brasil
                Author notes
                Endereço para correspondência Alexandre Pedro Nicolini Centro de Traumatologia do Esporte, Rua Estado de Israel 636, Vila Clementino, São Paulo, SP, 04022-001Brasil apnicolini@ 123456uol.com.br
                Author information
                http://orcid.org/0000-0002-5238-7388
                http://orcid.org/0000-0002-0581-1879
                http://orcid.org/0000-0001-7671-8113
                http://orcid.org/0000-0002-5935-4490
                Article
                Publisher ID: 2000054pt
                DOI: 10.1055/s-0040-1715514
                PMC ID: 8249055
                PubMed ID: 34239195
                SO-VID: 20e7736b-6104-4f04-b683-8816e6f7a34c
                Copyright © Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ )
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.

                History
                Date received : 07 March 2020
                Date accepted : 01 June 2020
                Categories
                Subject: Artigos Originais
                Subject: Artroscopia e Traumatologia do Esporte

                Keywords: osteoarthrosis,osteotomy,sports,tibia
                Data availability:
                Keywords: osteoarthrosis, osteotomy, sports, tibia

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