Puzzitiello Richard N, Liu Joseph N, Garcia Grant H, Redondo Michael L, Forlenza Enrico M, Agarwalla Avinesh, Yanke Adam B, Cole Brian J
Department of Orthopedic Surgery, Tufts University Medical Center, Boston, Massachusetts, USA.
Department of Orthopedic Surgery, Loma Linda Medical Center, Loma Linda, California, USA.
Orthop J Sports Med. 2020 Dec 3;8(12):2325967120965966. doi: 10.1177/2325967120965966. eCollection 2020 Dec.
Distal femoral varus osteotomy (DFVO) is a well-described procedure to address valgus deformity of the knee. There is a paucity of information available regarding patients' ability to return to work (RTW) after DFVO.
To report the objective findings for RTW rates and times for patients receiving a DFVO for lateral compartment osteoarthritis secondary to valgus deformity of the knee.
Cohort study; Level of evidence, 3.
This was a retrospective study of patients who received a lateral-wedge opening DFVO. Patients must have worked within 3 years before their operation to be included for analysis. Patients were contacted at a minimum of 2 years postoperatively for interview and questionnaire evaluation, including a subjective work questionnaire, visual analog scale (VAS) for pain, Single Assessment Numerical Evaluation (SANE), and a satisfaction questionnaire.
Overall, 32 patients were contacted at a mean follow-up of 7.1 ± 4.1 years (range, 2.2-13.3 years). The mean ± SD age at the time of surgery was 30.8 ± 8.8 years (range, 17.2-46.5 years), and 65.6% of patients were female. Eleven patients (34.4%) received a concomitant meniscal allograft transplant, and 12 (37.5%) received a cartilage grafting procedure. The average VAS pain score decreased significantly from 6.1 preoperatively to 3.2 postoperatively ( = .03). All patients were able to RTW, at a mean time of 6.0 ± 13.2 months postoperatively (range, 0-72 months). When stratified by work intensity, the average time to return was 13.8, 3.1, 2.7, and 2.9 months for high, moderate, light, and sedentary occupations, respectively. There was no significant difference between these RTW times ( = .16), although this analysis may have been limited by the small sample size. Four patients whose work was classified as heavy work (50%) and 3 whose work was classified as moderate work (18.8%) either switched jobs or kept the same job with lighter physical duties as a result of their procedures.
In a young and active population, DFVO for valgus deformity reliably afforded the ability to RTW within a relatively short time for patients with sedentary, light, and moderate occupational demands. However, patients with moderate- to high-intensity occupational demands may be unable to RTW at their preoperative level.
股骨远端内翻截骨术(DFVO)是一种用于治疗膝关节外翻畸形的成熟手术。关于DFVO术后患者恢复工作(RTW)能力的信息较少。
报告因膝关节外翻畸形继发外侧间室骨关节炎而接受DFVO治疗的患者的RTW率和时间的客观研究结果。
队列研究;证据等级为3级。
这是一项对接受外侧楔形撑开DFVO手术患者的回顾性研究。纳入分析的患者必须在手术前3年内有工作经历。术后至少2年对患者进行联系,进行访谈和问卷调查评估,包括主观工作问卷、疼痛视觉模拟量表(VAS)、单项评估数值评定法(SANE)和满意度问卷。
总体而言,共联系了32例患者,平均随访时间为7.1±4.1年(范围为2.2 - 13.3年)。手术时的平均年龄±标准差为30.8±8.8岁(范围为17.2 - 46.5岁),65.6%的患者为女性。11例患者(34.4%)同时接受了半月板同种异体移植,12例患者(37.5%)接受了软骨移植手术。VAS疼痛评分从术前的6.1显著降至术后的3.2(P = 0.03)。所有患者均能够恢复工作,术后平均恢复时间为6.0±13.2个月(范围为0 - 72个月)。按工作强度分层时,高、中、轻和久坐职业的平均恢复时间分别为13.8、3.1及2.7和2.9个月。这些RTW时间之间无显著差异(P = 0.16),不过该分析可能因样本量小而受到限制。4例工作被归类为繁重工作的患者(50%)和3例工作被归类为中等工作的患者(18.8%)因手术而更换了工作或从事了体力要求较低的相同工作。
对于年轻且活跃的人群,因外翻畸形接受DFVO手术的患者,对于从事久坐、轻度和中度职业需求的患者,能够在相对较短的时间内可靠地恢复工作。然而,有中度至高度职业需求的患者可能无法恢复到术前的工作水平。