The purpose of this study was to examine the outcomes following opening-wedge high tibial osteotomy (HTO) focusing on return to sports in a consecutive series of highly active patients who underwent a unilateral osteotomy procedure.

Methods

Sixty-three consecutive patients with preoperative Tegner’s activity score of 5 or more who underwent unilateral HTO for varus osteoarthritic knees were included in this study. The clinical results were evaluated using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the International Knee Documentation Committee (IKDC) Subjective Score. In radiological assessment, the following parameters were measured in full-length weightbearing radiographs both pre- and postoperatively; mechanical tibiofemoral angle (mTFA), mechanical medial proximal tibial angle (mMPTA), and joint-line convergence angle (JLCA). As regards postoperative functional recovery, inability to return to sports activities and reduction in the activity level on the Tegner scale were considered as failure to return to sports. Potential prognostic factors examined with logistic regression analysis were as follows: age ≥ 70, body mass index > 25, postoperative mTFA > 3° valgus or < 0° varus, postoperative mMPTA > 90°, opening gap > 10mm, and Kellgren-Laurence classification (KL) grade 4.

Results

At 2 years after surgery, the KOOS and the IKDC score improved from 231 to 437 and from 34 to 72, respectively with significant improvements in both scores. As for functional recovery, 50 patients (79.4%) could return to high-impact sports activities at the pre-symptomatic level with a mean time period of 8.0 months. Statistical analysis of the prognostic factors showed that postoperative mTFA > 3° valgus, opening gap > 10 mm and KL grade 4 were the factors significantly affecting the postoperative return to sports.

Conclusions

Presence of postoperative mTFA > 3° valgus, opening gap > 10mm and KL grade 4 were identified as risk factors impairing postoperative return to high-impact sports.

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The distribution of femoral and tibial coronal alignment in Japan: a multicentric retrospective study of patients with knee osteoarthritis ePoster Presentation Takashi Tsuda, JAPAN Kazunori Hino, MD, PhD, JAPAN Tatsuhiko Kutsuna, MD, PhD, JAPAN Kunihiko Watamori, MD, JAPAN Tomofumi Kinoshita, MD, PhD, JAPAN Takafumi Hiranaka, MD, PhD, JAPAN Eiichi Shiigi, MD、PhD, JAPAN Hiroshi Inui, MD, PhD, JAPAN Kohei Kawaguchi, MD, PhD, JAPAN Masaki Takao, Prof., JAPAN
A Novel Safety Device For Bicortical Fixation In Medial-opening Wedge High Tibial Osteotomy Reduces Correction Loss And Promotes Bone Union ePoster Presentation Shunya Otani, MD, PhD, JAPAN Masafumi Itoh, MD, PhD, JAPAN Umito Kuwashima, MD, PhD, JAPAN Junya Itou, MD, PhD, JAPAN Ken Okazaki, MD, PhD, Prof., JAPAN
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Clinical Results After Double Level Osteotomy For Knee Osteoarthritis With Joint-Line Obliquity ePoster Presentation Mitsuki Shimizu, MD, JAPAN Hiroshi Nakayama, MD., PhD. Associate Professor., JAPAN Akira Kawai, MD, JAPAN Yoshitaka Nakao, MD, JAPAN Ryo Kanto, MD, PhD., JAPAN Shintaro Onishi, MD, PhD, JAPAN Tomoya Iseki, MD, PhD, JAPAN Shinichi Yoshiya, MD, JAPAN Toshiya Tachibana, MD, PhD, JAPAN
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Does The Use Of A Non-Tourniquet During High Tibial Osteotomy Decrease Postoperative Pain? A Systematic Review And Meta-Analysis ePoster Presentation Hirotaka Nakashima, MD, PhD, JAPAN Pattanaket Cheewa, THAILAND Keisuke Nakayama, MD, PhD, JAPAN Shinichiro Takada, MD, JAPAN Soshi Uchida, MD, PhD, JAPAN
The Benefits Of A Percutaneous Supplemental Screw To Reinforce The Hinge Of A Medial Open Wedge Tibial Osteotomy ePoster Presentation Hsuan‑Hsiao Ma, MD, TAIWAN En-Rung Chiang, MD, PhD, TAIWAN
The Impact Of Medial Opening Wedge High Tibial Osteotomy On Patellar Height And Tibial Tubercle – Trochlear Groove Distance: Prospective Analysis Of 54 Consecutive Cases. ePoster Presentation Coral Castillejo Iniesta, MD, SPAIN Giacomo Dal Fabbro, MD, AUSTRALIA Margherita Bonaiuti, PhD, ITALY Claudio Belvedere, PhD, ITALY Alberto Leardini, DPhil, ITALY Fabio Norvillo, ITALY Alberto Grassi, PhD, ITALY Stefano Zaffagnini, MD, Prof., ITALY Fulvia Taddei, ENG, ITALY
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Patient Specific Instrument-Guided Distal Femur Biplanar Osteotomy of Valgus Knees ePoster Presentation Jui Cheng Lin, MD, TAIWAN Jia-Lin Wu, MD, MS, TAIWAN
Effect Of Meniscal Tear Patterns And Preoperative Cartilage Status On Joint Space Width After Medial Opening-Wedge High Tibial Osteotomy ePoster Presentation Sang-Min Lee, Prof., KOREA, REPUBLIC OF Lih Wang, MD, PhD, KOREA, REPUBLIC OF Jung Shin Kim, Prof., KOREA, REPUBLIC OF Won Chul Shin, Prof., KOREA, REPUBLIC OF
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Knees With Anteromedial Osteoarthritis Show A Substantial Variability In Coronal Plane Alignment Of The Knee (Cpak) Phenotypes: Prevalence And Phenotypic Changes Following Medial Unicompartmental Knee Arthroplasty ePoster Presentation Gaby Victoria Ten Noever De Brauw, NETHERLANDS Tarik Bayoumi, MD, NETHERLANDS Lindsey Ruderman, BA, UNITED STATES Gino M. M. J. Kerkhoffs, MD, PhD, Prof., NETHERLANDS Andrew D. Pearle, MD, UNITED STATES Hendrik Aernout Zuiderbaan, MD PhD, NETHERLANDS
Normative Values Of Radiographic Parameters In Coronal Plane Lower Limb Alignment In Japanese General Population; Cross-Sectional Study In Iwaki Cohort ePoster Presentation Ryoto Kura, MD, JAPAN Eiji Sasaki, MD, PhD, JAPAN Takahiro Tsushima, MD, PhD, JAPAN Yukiko Sakamoto, MD, PhD, JAPAN Kyota Ishibashi, MD, JAPAN Yuka Kimura, MD, PhD, JAPAN Eiichi Tsuda, Prof., JAPAN Yasuyuki Ishibashi, MD, JAPAN
Trochlear Cartilage Regeration After Arthroscopic Marrow Stimulation Combined With High Tibial Osteotomy And 3-Dimensionally Measured Patellofemoral Biomechanical Parameters ePoster Presentation Byeong-Hun Jeon, MD, KOREA, REPUBLIC OF Se-Han Jung, MD, KOREA, REPUBLIC OF Min Jung, MD, PhD, KOREA, REPUBLIC OF Kwangho Chung, MD, KOREA, REPUBLIC OF Hyun-Soo Moon, MD, PhD, KOREA, REPUBLIC OF Sung-Hwan Kim, MD, PhD, KOREA, REPUBLIC OF
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Comparison of Perioperative Leg Length Change Between the Medial Closing Wedge and Lateral Opening Wedge Distal Femoral Osteotomy for Valgus Knee Deformity ePoster Presentation Shintaro Onishi, MD, PhD, JAPAN Youngji Kim, MD, PhD, JAPAN Hiroshi Nakayama, MD., PhD. Associate Professor., JAPAN Ahmed Mabrouk, MBBCH (Hons), MRCS, FRCS (Trauma & Orthopaedics), UNITED KINGDOM Matthieu Ollivier, Prof, MD, PhD , FRANCE
Relationship Between Proximal Tibio-Fibular Overlap And Lower Limb Torsion In An Asian Population ePoster Presentation Ashton Tan, MBBS, SINGAPORE Xinyu Tao, MBBS, SINGAPORE Don Koh, MBBS, BSc, MRCS, MMED, SINGAPORE Kong Hwee Lee, MBBS, FRCS (Ortho), SINGAPORE Hamid Rahmatullah Bin Abd Razak, MBBS, FRCSEd (Ortho), FRCSGlasg (Tr & Orth), FAMS, SINGAPORE Junwei Soong, MBBS, MRCS (Edin), MMED (Ortho), FRCS (Edin), SINGAPORE
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Medial Degenerative Disease of the Knee Without Radiographic Osteoarthritis is a Good Indication for Medial Open Wedge High Tibial Osteotomy ePoster Presentation Junya Itou, MD, PhD, JAPAN Umito Kuwashima, MD, PhD, JAPAN Masafumi Itoh, MD, PhD, JAPAN Ken Okazaki, MD, PhD, Prof., JAPAN
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Patellar Height Decrease After Opening Wedge High Tibial Osteotomy While No Change in Closing Wedge Technique ePoster Presentation Robert Ferrer-Rivero, MD, SPAIN Oriol Pujol, MD, SPAIN Josep Ferrer-Rivero, MD, SPAIN Gabriel Olive Far, MD, PhD, SPAIN
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Comparison Of Clinical Outcomes Between High Tibial Osteotomy And Total Knee Arthroplasty In Older Patients With Severe Osteoarthritis ePoster Presentation Kodai Hamaoka, MD, JAPAN Shinichiro Okimura, MD, PhD, JAPAN Kazushi Horita, MD, JAPAN Yasutoshi Ikeda, MD,PhD, JAPAN Yohei Okada, MD,PhD, JAPAN Tomoaki Kamiya, MD, JAPAN Atsushi Teramoto, MD, PhD, JAPAN
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Same Day Discharge Knee Osteotomy: The Results of a High-Volume Canadian Centre ePoster Presentation Nicola Denese Mackay, BMSc (Hons), MB ChB (Hons), FRCS (Tr&Orth), UNITED KINGDOM Hana Marmura, MPT, PhD, UNITED STATES Vincent Roy, MD, MSc, CANADA Ryan M. Degen, MD, FRCSC, CANADA Robert Litchfield, MD, FRCSC, CANADA J. Robert Giffin, MD, FRCSC, MBA, CANADA Alan Getgood, MD, FRCS(Tr&Orth), DipSEM, QATAR
Tibial Slope Variation After Opening Wedge High Tibial Osteotomy While No Change in Closing Wedge Technique ePoster Presentation Robert Ferrer-Rivero, MD, SPAIN Oriol Pujol, MD, SPAIN Josep Ferrer-Rivero, MD, SPAIN Gabriel Olive Far, MD, PhD, SPAIN
A Lateral Hinge Screw Significantly Resists Varus Stress In Biplanar Medial Closing Wedge Distal Femoral Osteotomy ePoster Presentation Benjamin Main, DO, UNITED STATES Matthieu Ollivier, Prof, MD, PhD , FRANCE Pooyan Abbasi, MSc, UNITED STATES Wiemi A Douoguih, MD, UNITED STATES
Support Instruments Provide Remarkable Stability in Medial Closed Wedge Distal Femoral Osteotomy -A Finite Element Analysis- ePoster Presentation Umito Kuwashima, MD, PhD, JAPAN Masafumi Itoh, MD, PhD, JAPAN Junya Itou, MD, PhD, JAPAN Ken Okazaki, MD, PhD, Prof., JAPAN
Small Changes Of Femoral Torsion After Distal Femoral Osteotomy Using Patient-Specific Instruments Even In Case Of A Hinge Fracture ePoster Presentation Lukas Jud, MD, SWITZERLAND Georgios Neopoulos, MD, SWITZERLAND Sandro Hodel, MD, SWITZERLAND Lazaros Vlachopoulos, MD, PhD, SWITZERLAND Sandro Fucentese, Prof MD, SWITZERLAND
Precision of Tibiofemoral Angle Assessment: A Comparative Analysis of Long Leg Radiographs and Magnetic Resonance Imaging ePoster Presentation Danaithep Limskul, MD, THAILAND Theeraphat Kotimanusvanij, MD, THAILAND Napatpong Thamrongskulsiri, MD, THAILAND Thun Itthipanichpong, MD, THAILAND Thanathep Tanpowpong, MD, THAILAND Somsak Kuptniratsaikul, MD, THAILAND
Medial Open Wedge High Tibial Osteotomy with Bone Marrow Derived Stem Cell for Medial Knee Osteoarthritis ePoster Presentation WhanYong Chung, MD, PhD, Prof, KOREA, REPUBLIC OF Hyun Hee Lee, MD, KOREA, REPUBLIC OF
Smoking Is Associated With Poor Outcomes And Return To Work Following Opening Wedge High Tibial And Distal Femoral Osteotomy ePoster Presentation Griffith G. Gosnell, MS, UNITED STATES Katherine L. Esser, BS, UNITED STATES Peter Commisso, BS, UNITED STATES Michael Moore, BA, UNITED STATES Nathaniel P. Mercer, MD, UNITED STATES Heath Patrick Gould, MD, UNITED STATES Anil S. Ranawat, MD, UNITED STATES Seth L. Sherman, MD, UNITED STATES Michael J Alaia, MD, UNITED STATES
Three-Dimensional Change in Tibiofemoral Relationship After High Tibial Osteotomy: Medial Open Wedge Versus Lateral Closed Wedge ePoster Presentation Yuta Tachibana, M.D., Ph.D., JAPAN Kazutaka Kinugasa, MD, PhD, JAPAN Kunihiko Hiramatsu, MD, PhD, JAPAN Yuzo Yamada, MD, PhD, JAPAN Ayaka Tanaka, MD, JAPAN Yoshinari Tanaka, MD, PhD, JAPAN
Changes In Coronal Tibial Alignment In Anterior Tibial Closing Wedge Osteotomy Are Caused By Axial Rotation Of The Hinge ePoster Presentation Julius Watrinet, MD, Dr. med., GERMANY Philipp Blum, MD, GERMANY Julian Mehl, MD, GERMANY Sebastian Siebenlist, MD, MHBA, Prof., GERMANY Julian Fürmetz, PD MD, GERMANY
Cartilage repair after opening -wedge high tibial osteotomy with autologous osteochondral transplantation for spontaneous osteonecrosis of the knee and osteoarthritis ePoster Presentation Shogo Mukai, MD, JAPAN Yasuaki Nakagawa, MD, JAPAN
Medial Open Wedge High Tibial Osteotomy: Risk Factors for Early Conversion to Total Knee Arthroplasty ePoster Presentation Nicola Denese Mackay, BMSc (Hons), MB ChB (Hons), FRCS (Tr&Orth), UNITED KINGDOM Adit Rajesh Maniar, MBBS, MS Orthopaedics, DNB Orthopaedics, INDIA Lyndsay Somerville, PhD, CANADA Brent Lanting, MD, FRCSC, CANADA Alan Getgood, MD, FRCS(Tr&Orth), DipSEM, QATAR
Influence of Preoperative Bone Marrow Lesions on Postoperative Cartilage Improvement After Open Wedge High Tibial Osteotomy ePoster Presentation Kosuke Kawamura, MD, JAPAN Eiji Sasaki, MD, PhD, JAPAN Takahiro Tsushima, MD, PhD, JAPAN Yuka Kimura, MD, PhD, JAPAN Yukiko Sakamoto, MD, PhD, JAPAN Eiichi Tsuda, Prof., JAPAN Yasuyuki Ishibashi, MD, JAPAN
Influence Of Different Standing Positions On Anatomical Parameters Of Coronal Whole-Leg Weightbearing Radiographs In Preoperative Planning For High Tibial Osteotomy ePoster Presentation Tomoaki Kamiya, MD, JAPAN Kodai Hamaoka, MD, JAPAN Yohei Okada, MD,PhD, JAPAN Yasutoshi Ikeda, MD,PhD, JAPAN Kazushi Horita, MD, JAPAN Atsushi Teramoto, MD, PhD, JAPAN
Neutral to Slightly Undercorrected Mechanical Leg Alignment Provides Superior Long-Term Results in Patients Undergoing Matrix-Associated Autologous Chondrocyte Implantation ePoster Presentation Johannes Weishorn, MD, GERMANY Johanna Wiegand, MD, GERMANY Severin Zietzschmann, MD, GERMANY Raphael Trefzer, MD, GERMANY Kevin-Arno Koch, MD, GERMANY Tilman Walker, GERMANY
Novel Safety Device Eliminates Neurovascular Injury In Medial-opening Wedge High Tibial Osteotomy ePoster Presentation Masafumi Itoh, MD, PhD, JAPAN Junya Itou, MD, PhD, JAPAN Umito Kuwashima, MD, PhD, JAPAN Shunya Otani, MD, PhD, JAPAN Ken Okazaki, MD, PhD, Prof., JAPAN
Medial Hinge Fracture After Closing Wedge High Tibial Osteotomy: Classification and Risk Factor Analysis of a Neglected Complication ePoster Presentation Gian Andrea Lucidi, MD, ITALY Giovanni Balboni, MD, ITALY Luca Solaro, MD, ITALY Margherita Bonaiuti, PhD, ITALY Constantinos Drousiotis, MD, ITALY Giacomo Dal Fabbro, MD, AUSTRALIA Alberto Grassi, PhD, ITALY Stefano Di Paolo, Eng, PhD, ITALY Stefano Zaffagnini, MD, Prof., ITALY
Double Level Osteotomy Provides Fairly Satisfactory Mid-term Outcomes in Patients with Symptomatic Severe Varus Osteoarthritic Knee. ePoster Presentation Ryo Ueshima, MD, JAPAN Shintaro Onishi, MD, PhD, JAPAN Tomoya Iseki, MD, PhD, JAPAN Ryo Kanto, MD, PhD., JAPAN Ryuichi Gejo, MD, PhD, JAPAN Shinichi Yoshiya, MD, JAPAN Toshiya Tachibana, MD, PhD, JAPAN Hiroshi Nakayama, MD., PhD. Associate Professor., JAPAN
Double-Level Osteotomy: A Systematic Review Of Patient-Reported Outcomes, Conversion To Total Knee Arthroplasty, Complications, And Alignment ePoster Presentation Anil S. Ranawat, MD, UNITED STATES Gabrielle Dituri, BS, UNITED STATES Akshay Raghuram, BS, UNITED STATES Nathan Varady, MD, MBA, UNITED STATES
Management of postoperative deep infection in osteotomy around the knee ePoster Presentation Hiroki Miya, MD, JAPAN Hiroshi Nakayama, MD., PhD. Associate Professor., JAPAN Tomoya Iseki, MD, PhD, JAPAN Shintaro Onishi, MD, PhD, JAPAN Ryo Kanto, MD, PhD., JAPAN Yoshitaka Nakao, MD, JAPAN Akira Kawai, MD, JAPAN Shunsuke Akai, MD, JAPAN Shinichi Yoshiya, MD, JAPAN Toshiya Tachibana, MD, PhD, JAPAN
Measuring Osteotomy Wedge Angle Is More Important Than Measuring Wedge Height In Open Wedge Osteotomies Around The Knee ePoster Presentation Julius Watrinet, MD, Dr. med., GERMANY Johannes Schlaich, Stud., GERMANY Romed Peter Vieider, MD, GERMANY Marco-Christopher Rupp, MD, GERMANY Julian Mehl, MD, GERMANY Sebastian Siebenlist, MD, MHBA, Prof., GERMANY Armin Runer, PD MD, GERMANY
Anterior Closing Wedge High Tibial Osteotomy and a Third ACL Reconstruction: Will These Patients Return to Impact Sports? ePoster Presentation Ahmed Mabrouk, MBBCH (Hons), MRCS, FRCS (Trauma & Orthopaedics), UNITED KINGDOM Matthieu Ollivier, Prof, MD, PhD , FRANCE
Return to Sports after Inverted V-Shaped High Tibial Osteotomy for Medial Knee Osteoarthritis - Comparison with Medial Opening Wedge High Tibial Osteotomy - ePoster Presentation Taku Ebata, MD, PhD, JAPAN Eiji Kondo, MD, PhD, JAPAN Koji Iwasaki, MD, PhD, JAPAN Dai Sato, MD, PhD, JAPAN Masatake Matsuoka, PhD, JAPAN Tomohiro Onodera, MD, PhD, JAPAN Kazunori Yasuda, MD, PhD, Prof., JAPAN Tomonori Yagi, MD, PhD, JAPAN Norimasa Iwasaki, MD, PhD, JAPAN

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Return to sports after unilateral medial opening wedge high tibial osteotomy in highly active patients -Analysis of factors affecting functional recovery-

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Return to sports after unilateral medial opening wedge high tibial osteotomy in highly active patients -Analysis of factors affecting functional recovery-

Return to sports after unilateral medial opening wedge high tibial osteotomy in highly active patients -Analysis of factors affecting functional recovery-

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