Ekhtiari Seper, Haldane Chloe E, de Sa Darren, Simunovic Nicole, Musahl Volker, Ayeni Olufemi R
Division of Orthopaedic Surgery, Department of Surgery (D.d.S. and O.R.A.), and Centre for Evidence Based Orthopaedics, Department of Clinical Epidemiology and Biostatistics (N.S.), Michael G. DeGroote School of Medicine (S.E. and C.E.H.), McMaster University, Hamilton, Ontario, Canada.
Division of Orthopedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania.
J Bone Joint Surg Am. 2016 Sep 21;98(18):1568-77. doi: 10.2106/JBJS.16.00036.
The purpose of this study was to examine (1) timelines for return to sport and work following high tibial osteotomy (HTO), and (2) whether patients return to sport and work at levels similar to preoperative levels.
A systematic search was conducted across 3 databases (MEDLINE, Embase, and PubMed). Two reviewers independently screened the results for relevant articles. Data regarding patient demographics, indications, surgical technique, return to work and sport, and complication and failure rates were abstracted from eligible studies.
Nineteen studies were included, involving 1,189 patients (64% male, 21% female, 15% unspecified) and 1,224 knees. Mean age was 46.2 years (range, 16 to 80 years). Opening-wedge HTO was most commonly used, followed by closing-wedge HTO and hemicallotasis. Mean follow-up was 65.4 months (range, 8 to 253 months). Overall, 87.2% of patients returned to sport postoperatively, and 78.6% returned at an equal or greater level. Among competitive athletes, 54% returned to competition. Overall, 84.5% of patients returned to work postoperatively, and 65.5% returned at an equal or greater level. Approximately 90% of patients who returned to work or sport did so within 1 year. The complication rate was 5.8%, with infection being the most common complication; 7.0% of patients progressed to a total knee arthroplasty at a mean of 6.7 years (range, 0.8 to 15 years) following HTO.
The majority of patients undergoing HTO return to sport and work, and most return within 1 year of the operation. Most patients return to sport at a level equal to or greater than the preoperative level. Approximately two-thirds of patients return to an equal or greater level of physical work.
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
本研究的目的是探讨（1）高位胫骨截骨术（HTO）后恢复运动和工作的时间线，以及（2）患者恢复运动和工作的水平是否与术前水平相似。
对3个数据库（MEDLINE、Embase和PubMed）进行了系统检索。两名评审员独立筛选结果以查找相关文章。从符合条件的研究中提取有关患者人口统计学、适应证、手术技术、恢复工作和运动情况以及并发症和失败率的数据。
纳入19项研究，涉及1189例患者（64%为男性，21%为女性，15%未明确）和1224个膝关节。平均年龄为46.2岁（范围16至80岁）。最常用的是开放楔形HTO，其次是闭合楔形HTO和半骺延长术。平均随访时间为65.4个月（范围8至253个月）。总体而言，87.2%的患者术后恢复运动，78.6%的患者恢复到同等或更高水平。在竞技运动员中，54%恢复了比赛。总体而言，84.5%的患者术后恢复工作，65.5%的患者恢复到同等或更高水平。约90%恢复工作或运动的患者在1年内实现。并发症发生率为5.8%，感染是最常见的并发症；7.0%的患者在HTO术后平均6.7年（范围0.8至15年）进展为全膝关节置换术。
大多数接受HTO的患者恢复运动和工作，且大多数在术后1年内恢复。大多数患者恢复运动的水平等于或高于术前水平。约三分之二的患者恢复到同等或更高水平的体力工作。
治疗性四级证据。有关证据水平的完整描述，请参阅作者指南。
