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

Nicolini, Alexandre Pedro; Christiano, Eduardo Suñe; Abdalla, Rene Jorge; Cohen, Moises; de Carvalho, Rogério Teixeira

doi:10.1055/s-0040-1715514

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Sumário

Original Articles, Sport Arthroscopy and Traumatology • Rev. bras. ortop. 56 (3) • May-Jun 2021 • https://doi.org/10.1055/s-0040-1715514 copy

Return to Sports After High Tibial Osteotomy Using the Opening Wedge Technique^* * Study performed at the Sports Traumatology Center, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

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.

Keywords
osteoarthrosis; osteotomy; sports; tibia

Finding		Mean	Median	Standard Deviation	Q1	Q3	n	CI	p value
Range of motion	Pre-	108.33	105.0	12.64	101.5	115.0	12	7.15	<0.001
Range of motion	Post-	123.92	124.0	7.49	119.5	130.0	12	4.24	<0.001
Anatomical axis	Pre-	-3.32	-3.9	2.75	-5.4	-2.0	12	1.56	<0.001
Anatomical axis	Post-	6.38	6.5	1.89	4.8	8.0	12	1.07	<0.001
Visual analog scale for pain	Pre-	6.83	6.4	1.12	6.0	7.9	12	0.64	<0.001
Visual analog scale for pain	Post-	3.53	3.4	0.77	3.1	4.1	12	0.44	<0.001

			Range of Motion			Anatomical Axis			Analog Visual Scale for Pain			Healing time	Lysholm Score	IKDC Score
			Pre-	Post-	Gain	Pre-	Post-	Gain	Pre-	Post-	Gain	Healing time	Lysholm Score	IKDC Score
Range of motion	Post-	Corr	76.50%
	Post-	p-value	0.004
	Gain	Corr	-67.00%	-19.70%
	Gain	p-value	0.017	0.539
	Pre-	Corr	57.90%	58.00%	-42.40%
	Pre-	p-value	0.049	0.048	0.169
Anatomical axis	Post-	Corr	21.40%	11.30%	-8.70%	35%
	Post-	p-value	0.503	0.727	0.789	0.264
	Gain	Corr	-56.10%	-74.50%	32.70%	-87.90%	-4.60%
	Gain	p-value	0.058	0.005	0.299	<0.001	0.888
	Pre-	Corr	7.80%	-3.40%	-19.80%	-32.50%	4.40%	21.20%
	Pre-	p	0.810	0.917	0.538	0.303	0.892	0.506
Visual analog scale for pain	Post-	Corr	7.20%	-7.80%	-20.90%	3.20%	-43.80%	-1.20%	17.20%
	Post-	p-value	0.824	0.811	0.514	0.922	0.155	0.97	0.594
	Gain	Corr	0.90%	-6.10%	-5.30%	48.50%	-3.90%	-27.50%	-87.90%	15.70%
	Gain	p-value	0.978	0.874	0.869	0.110	0.905	0.388	< 0.001	0.626
Healing time		Corr	50.80%	61.20%	-37.60%	34.40%	-47.50%	-58.30%	-19.90%	24.60%	19.60%
Healing time		p-value	0.092	0.035	0.228	0.274	0.119	0.047	0.536	0.441	0.541
Lysholm score		Corr	64.60%	52.80%	-52.90%	65.40%	11.10%	-67.40%	9.80%	33.70%	9.00%	30.80%
Lysholm score		p-value	0.023	0.077	0.021	0.731	0.016	0.763	0.284	0.781	0.331
IKDC score		Corr	60.80%	53.40%	-23.80%	43.90%	45.60%	-36.40%	44.90%	-3.70%	-32.00%	-6.50%	54.90%
IKDC score		p-value	0.036	0.074	0.456	0.153	0.136	0.244	0.144	0.909	0.311	0.842	0.064
Body mass index		Corr	-39.20%	-45.20%	-12.00%	-52.20%	-51.90%	34.60%	7.10%	14.20%	-5.10%	12.70%	-12.00%	-68.80%
Body mass index		p-value	0.208	0.140	0.709	0.082	0.084	0.271	0.827	0.659	0.875	0.693	0.711	0.044

Arthrosis Grade (Ahlback)		Mean	Median	Standard Deviation	Q1	Q3	n	CI	p-value
Preoperative anatomical axis	Grade II	-2.80	-2.2	3.55	-6.2	-1.2	5	3.11	0.808
Preoperative anatomical axis	Grade III	-3.69	-4.2	2.25	-4.8	-3.5	7	1.67	0.808
Pain gain	Grade II	-3.48	-4.0	0.98	-4.0	-3.0	5	0.86	0.935
Pain gain	Grade III	-3.17	-3.2	1.34	-4.2	-2.5	7	0.99	0.935
Lysholm score	Grade II	82.00	82.0	9.27	76.0	90.0	5	8.13	0.624
Lysholm score	Grade III	85.14	88.0	8.07	80.0	90.0	7	5.98	0.624
IKDC score	Grade II	78.40	80.0	5.18	74.0	82.0	5	4.54	0.414
IKDC score	Grade III	74.00	76.0	8.16	69.0	79.0	7	6.05	0.414
Healing time	Grade II	9.40	10.0	1.34	8.0	10.0	5	1.18	0.618
Healing time	Grade III	9.00	9.0	1.29	8.5	9.5	7	0.96	0.618

Sociedade Brasileira de Ortopedia e Traumatologia Al. Lorena, 427 14º andar, 01424-000 São Paulo - SP - Brasil, Tel.: 55 11 2137-5400 - São Paulo - SP - Brazil
E-mail: rbo@sbot.org.br

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[1] Address for correspondence Alexandre Pedro Nicolini, Centro de Traumatologia do Esporte, Rua Estado de Israel, 636, Vila Clementino, São Paulo, SP, 04022-001, Brazil (e-mail: apnicolini@uol.com.br).

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Return to Sports After High Tibial Osteotomy Using the Opening Wedge Technique* * Study performed at the Sports Traumatology Center, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.

Abstract

Objective

Methods

Results

Conclusion

Return to Sports After High Tibial Osteotomy Using the Opening Wedge Technique^* * Study performed at the Sports Traumatology Center, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.