Philipp Minzlaff1,2, Matthias J Feucht1, Tim Saier1,3, Matthias Cotic1, Johannes E Plath1, Andreas B Imhoff4, Stefan Hinterwimmer1,5. 1. Department of Orthopaedic Sports Medicine, Klinikum rechts der Isar, Technische Universität Muenchen, Ismaningerstr. 22, 81675, Munich, Germany. 2. Department for Sport Traumatology, Knee- and Shoulder Surgery, Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, Frankfurt, Germany. 3. Berufsgenossenschaftliche Unfallklinik Murnau, Murnau, Germany. 4. Department of Orthopaedic Sports Medicine, Klinikum rechts der Isar, Technische Universität Muenchen, Ismaningerstr. 22, 81675, Munich, Germany. a.imhoff@lrz.tum.de. 5. Sportsclinic Germany, Munich, Germany.
Abstract
PURPOSE: To evaluate sporting activity following osteochondral autologous transfer (OAT) combined with valgus high tibial osteotomy (HTO) in young and active patients with focal osteochondral defects of the medial femoral condyle and concomitant varus malalignment. METHODS: Thirty patients with focal osteochondral defects of the medial femoral condyle and varus malalignment >2° were enrolled. All patients were active in sports on a regular base prior to surgery (lifetime), but were unable to perform sports at the time of surgery. Sporting activity 1 year preoperatively and at final follow-up was compared using a previously published sports questionnaire, which assesses sports level, number of sports disciplines, sports frequency, sports duration and the participation in 32 common sports disciplines. Additionally, the Tegner activity scale and the Activity Rating Scale were used. RESULTS: After a mean follow-up of 6.9 years (2.5-9.8; SD 2.4), 76.7 % of patients were participating in sports on a regular basis (Fig. 2). Compared to 1 year preoperatively, there was no difference (n.s.) with regard to sports, the number of sports disciplines, sports frequency and sports duration (Fig. 4). The median Tegner activity scale measured preoperatively 5.0 (2.0-7.0) and post-operatively 5.0 (4.0-7.0) points (Fig. 3), and the ARS changed from 5.7 to 5.3 points (n.s.). The different types of sports disciplines were comparable between 1 year preoperatively and at follow-up. CONCLUSION: A high return to sports rate and an activity level comparable to the state at 1 year preoperatively can be expected in young and active patients after combined OAT and valgus HTO. This seems to be relevant in clinical practice when planning, indicating and performing these complex procedures. LEVEL OF EVIDENCE: IV.
PURPOSE: To evaluate sporting activity following osteochondral autologous transfer (OAT) combined with valgus high tibial osteotomy (HTO) in young and active patients with focal osteochondral defects of the medial femoral condyle and concomitant varus malalignment. METHODS: Thirty patients with focal osteochondral defects of the medial femoral condyle and varus malalignment >2° were enrolled. All patients were active in sports on a regular base prior to surgery (lifetime), but were unable to perform sports at the time of surgery. Sporting activity 1 year preoperatively and at final follow-up was compared using a previously published sports questionnaire, which assesses sports level, number of sports disciplines, sports frequency, sports duration and the participation in 32 common sports disciplines. Additionally, the Tegner activity scale and the Activity Rating Scale were used. RESULTS: After a mean follow-up of 6.9 years (2.5-9.8; SD 2.4), 76.7 % of patients were participating in sports on a regular basis (Fig. 2). Compared to 1 year preoperatively, there was no difference (n.s.) with regard to sports, the number of sports disciplines, sports frequency and sports duration (Fig. 4). The median Tegner activity scale measured preoperatively 5.0 (2.0-7.0) and post-operatively 5.0 (4.0-7.0) points (Fig. 3), and the ARS changed from 5.7 to 5.3 points (n.s.). The different types of sports disciplines were comparable between 1 year preoperatively and at follow-up. CONCLUSION: A high return to sports rate and an activity level comparable to the state at 1 year preoperatively can be expected in young and active patients after combined OAT and valgus HTO. This seems to be relevant in clinical practice when planning, indicating and performing these complex procedures. LEVEL OF EVIDENCE: IV.
Entities:
Keywords:
Cartilage; High tibial osteotomy; Osteochondral defect; Osteochondral transfer; Return to sports; Sporting activity; Varus malalignment
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