Joseph N Liu1, Avinesh Agarwalla2, Grant H Garcia3, David R Christian4, Anirudh K Gowd5, Adam B Yanke6, Brian J Cole7. 1. Department of Orthopedic Surgery, Loma Linda Medical Center, Loma Linda, California, U.S.A. 2. Department of Orthopedic Surgery, Westchester Medical Center, Valhalla, New York, U.S.A. 3. Seattle Orthopaedic Center, Seattle, Washington, U.S.A. 4. Department of Orthopedic Surgery, Northwestern Memorial Hospital, Chicago, Illinois, U.S.A. 5. Department of Orthopedic Surgery, Wake Forest University Baptist Medical Center, Winston-Salem, North Carolina, U.S.A. 6. Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, U.S.A. 7. Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, U.S.A.. Electronic address: brian.cole@rushortho.com.
Abstract
PURPOSE: (1) To examine the timeline of return to sport (RTS) and return to work (RTW) after high tibial osteotomy (HTO) with concomitant medial meniscal allograft transplant (MAT), (2) to evaluate the degree of function on RTS and RTW, and (3) to identify reasons patients do not return to sport- or work-related activity. METHODS: Patients undergoing HTO plus MAT were reviewed retrospectively at a minimum of 2 years postoperatively. The exclusion criterion was any concomitant procedure except cartilage restoration for focal full-thickness medial femoral condylar defects. Patients completed a subjective sport and work questionnaire, a visual analog scale for pain, the Single Assessment Numeric Evaluation, and a satisfaction questionnaire. RESULTS: Twenty-two patients (aged 35.1 ± 8.1 years) were included at 9.3 ± 3.7 years postoperatively. Sixteen patients participated in sports within 3 years before surgery, and 14 patients (87.5%) returned to sport by 9.7 ± 3.8 months postoperatively. Only 7 patients (43.8%) returned to their preinjury status. Eighteen patients were employed within 3 years before surgery, and all patients returned to work; however, only 16 patients (88.9%) returned at the same occupational intensity by 3.1 ± 2.4 months. The rates of RTW for light-, medium-, and heavy-intensity occupations were 100%, 75.0%, and 85.7%, respectively, whereas the duration of RTW was 2.1 months, 2.3 months, and 4.8 months, respectively. Of the patients, 20 (90.9%) reported at least 1 complaint postoperatively, with 13 patients (59.1%) returning to the operating room for recurrent symptoms, including 1 patient who received a knee replacement at 7.75 years postoperatively. CONCLUSIONS: In patients with medial meniscal deficiency and varus deformity, HTO plus MAT provided high rates of RTS (87.5%) and RTW (100%) by 9.7 months and 3.1 months, respectively. It is imperative that clinicians manage expectations because patients may RTS and RTW after HTO plus MAT; however, return to high-intensity activities or occupations may be unlikely or delayed. LEVEL OF EVIDENCE: Level IV, retrospective case series.
PURPOSE: (1) To examine the timeline of return to sport (RTS) and return to work (RTW) after high tibial osteotomy (HTO) with concomitant medial meniscal allograft transplant (MAT), (2) to evaluate the degree of function on RTS and RTW, and (3) to identify reasons patients do not return to sport- or work-related activity. METHODS:Patients undergoing HTO plus MAT were reviewed retrospectively at a minimum of 2 years postoperatively. The exclusion criterion was any concomitant procedure except cartilage restoration for focal full-thickness medial femoral condylar defects. Patients completed a subjective sport and work questionnaire, a visual analog scale for pain, the Single Assessment Numeric Evaluation, and a satisfaction questionnaire. RESULTS: Twenty-two patients (aged 35.1 ± 8.1 years) were included at 9.3 ± 3.7 years postoperatively. Sixteen patients participated in sports within 3 years before surgery, and 14 patients (87.5%) returned to sport by 9.7 ± 3.8 months postoperatively. Only 7 patients (43.8%) returned to their preinjury status. Eighteen patients were employed within 3 years before surgery, and all patients returned to work; however, only 16 patients (88.9%) returned at the same occupational intensity by 3.1 ± 2.4 months. The rates of RTW for light-, medium-, and heavy-intensity occupations were 100%, 75.0%, and 85.7%, respectively, whereas the duration of RTW was 2.1 months, 2.3 months, and 4.8 months, respectively. Of the patients, 20 (90.9%) reported at least 1 complaint postoperatively, with 13 patients (59.1%) returning to the operating room for recurrent symptoms, including 1 patient who received a knee replacement at 7.75 years postoperatively. CONCLUSIONS: In patients with medial meniscal deficiency and varus deformity, HTO plus MAT provided high rates of RTS (87.5%) and RTW (100%) by 9.7 months and 3.1 months, respectively. It is imperative that clinicians manage expectations because patients may RTS and RTW after HTO plus MAT; however, return to high-intensity activities or occupations may be unlikely or delayed. LEVEL OF EVIDENCE: Level IV, retrospective case series.
Authors: Avinesh Agarwalla; Joseph N Liu; David R Christian; Grant H Garcia; Gregory L Cvetanovich; Anirudh K Gowd; Adam B Yanke; Brian J Cole Journal: Cartilage Date: 2020-07-02 Impact factor: 3.117
Authors: Avinesh Agarwalla; Joseph N Liu; Grant H Garcia; Anirudh K Gowd; Richard N Puzzitiello; Adam B Yanke; Brian J Cole Journal: Cartilage Date: 2020-05-25 Impact factor: 3.117
Authors: Xin Zhou; Qi Liu; Tao Liang; Ping Xu; Yang Liu; Shijie Fu; Guoyou Wang; Lei Zhang Journal: Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi Date: 2021-06-15
Authors: Avinesh Agarwalla; Anirudh K Gowd; Joseph N Liu; Grant H Garcia; Gregory P Nicholson; Brian Forsythe; Anthony A Romeo; Nikhil N Verma Journal: Orthop J Sports Med Date: 2021-12-15
Authors: Marco-Christopher Rupp; Philipp W Winkler; Patricia M Lutz; Markus Irger; Philipp Forkel; Andreas B Imhoff; Matthias J Feucht Journal: Knee Surg Sports Traumatol Arthrosc Date: 2021-02-27 Impact factor: 4.342