Avinesh Agarwalla1, David R Christian2, Joseph N Liu3, Grant H Garcia4, Michael L Redondo5, Anirudh K Gowd6, Adam B Yanke7, Brian J Cole8. 1. Department of Orthopedic Surgery, Westchester Medical Center, Valhalla, New York, U.S.A. 2. Department of Orthopedic Surgery, Northwestern University Medical Center, Chicago, Illinois, U.S.A. 3. Department of Orthopedic Surgery, Loma Linda Medical Center, Loma Linda, California, U.S.A. 4. Seattle Orthopaedic Center, Seattle, Washington, U.S.A. 5. Department of Orthopedic Surgery, University of Illinois, Chicago, Illinois, U.S.A. 6. Department of Orthopaedic Surgery, Wake Forest University Baptist Medical Center, Winston-Salem, North Carolina, U.S.A. 7. Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, U.S.A. 8. Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, U.S.A.. Electronic address: brian.cole@rushortho.com.
Abstract
PURPOSE: To assess the timeline of return to work (RTW) following opening-wedge high tibial osteotomy (HTO) with concomitant osteochondral allograft transplantation (OCA) of the medial femoral condyle. METHODS: Consecutive patients undergoing HTO + OCA due to focal chondral deficiency and varus deformity were retrospectively identified and reviewed at a minimum of 2 years following surgery. Patients completed a subjective work questionnaire, a visual analog scale for pain, Single Assessment Numerical Evaluation, and a satisfaction questionnaire. RESULTS: Twenty-eight patients (average age: 36.0 ± 7.9 years) were included at 6.7 ± 4.1 years postoperatively. Twenty-six patients were employed before surgery and 25 patients (96.2%) returned to work following HTO + OCA. However, only 88.5% of patients were able to return to the same level of occupational intensity by 3.5 ± 2.9 months postoperatively. The rate of RTW to the same occupational intensity for sedentary, light, medium, and heavy intensity occupations was 100%, 100%, 88.9%, and 80% (P = .8), whereas the duration of RTW was 9.0 ± 7.1 months, 1.7 ± 1.4 months, 2.7 ± 0.9 months, and 4.2 ± 1.9 months (P = .006), respectively. Two patients (7.7%) underwent knee replacement by 5.3 ± 3.1 years postoperatively due to progression of osteoarthritis in the medial compartment. CONCLUSIONS: In patients with focal chondral deficiency and varus deformity, HTO + OCA provides a high rate of RTW (96.2%) by 3.5 ± 2.9 months postoperatively. However, patients with greater-intensity occupations may take longer to return to work than those with less physically demanding occupations. LEVEL OF EVIDENCE: IV, Retrospective Case Series.
PURPOSE: To assess the timeline of return to work (RTW) following opening-wedge high tibial osteotomy (HTO) with concomitant osteochondral allograft transplantation (OCA) of the medial femoral condyle. METHODS: Consecutive patients undergoing HTO + OCA due to focal chondral deficiency and varus deformity were retrospectively identified and reviewed at a minimum of 2 years following surgery. Patients completed a subjective work questionnaire, a visual analog scale for pain, Single Assessment Numerical Evaluation, and a satisfaction questionnaire. RESULTS: Twenty-eight patients (average age: 36.0 ± 7.9 years) were included at 6.7 ± 4.1 years postoperatively. Twenty-six patients were employed before surgery and 25 patients (96.2%) returned to work following HTO + OCA. However, only 88.5% of patients were able to return to the same level of occupational intensity by 3.5 ± 2.9 months postoperatively. The rate of RTW to the same occupational intensity for sedentary, light, medium, and heavy intensity occupations was 100%, 100%, 88.9%, and 80% (P = .8), whereas the duration of RTW was 9.0 ± 7.1 months, 1.7 ± 1.4 months, 2.7 ± 0.9 months, and 4.2 ± 1.9 months (P = .006), respectively. Two patients (7.7%) underwent knee replacement by 5.3 ± 3.1 years postoperatively due to progression of osteoarthritis in the medial compartment. CONCLUSIONS: In patients with focal chondral deficiency and varus deformity, HTO + OCA provides a high rate of RTW (96.2%) by 3.5 ± 2.9 months postoperatively. However, patients with greater-intensity occupations may take longer to return to work than those with less physically demanding occupations. LEVEL OF EVIDENCE: IV, Retrospective Case Series.
Authors: Jacob G Calcei; Kunal Varshneya; Kyle R Sochacki; Marc R Safran; Geoffrey D Abrams; Seth L Sherman Journal: Cartilage Date: 2021-05-08 Impact factor: 3.117
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; 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