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股骨远端截骨术后重返工作和运动:系统评价。

Return to Work and Sport After Distal Femoral Osteotomy: A Systematic Review.

机构信息

School of Medicine, University of California Irvine, Irvine, California.

Department of Orthopaedic Surgery, University of California Irvine, Orange, California.

出版信息

Sports Health. 2022 Sep-Oct;14(5):681-686. doi: 10.1177/19417381211041072. Epub 2021 Sep 6.

Abstract

CONTEXT

Distal femoral osteotomy (DFO) is a joint preservation procedure that corrects genu valgum deformities and patellofemoral maltracking, thereby restoring kinematics and unloading contact pressures in the lateral tibiofemoral and patellofemoral compartments.

OBJECTIVE

To evaluate the rates of return to work (RTW) and return to sport (RTS) after DFO for valgus malalignment and lateral compartment osteoarthritis through a systematic review of the literature.

DATA SOURCES

A systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted on the PubMed, Cochrane, and Embase databases.

STUDY SELECTION

The search terms AND ( OR ) were used. Studies in which patients underwent concomitant total knee arthroplasty were excluded.

STUDY DESIGN

Systematic review.

LEVEL OF EVIDENCE

Level 4 (systematic review of level 4 studies).

DATA EXTRACTION

Data included the number of patients, age, gender, laterality of operation, time to follow-up, rate of RTW and RTS, time to RTS, activity level on return, and activity level scores (Tegner, Marx, Lysholm, and the International Knee Documentation Committee). Risk of bias was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria.

RESULTS

Seven articles with 194 patients were included. The average age ranged from 19 to 49 years with a mean postoperative follow-up range of 36 to 90 months. RTW data were available for 125 patients, of whom 42.1% to 91.3% returned by final follow-up. Data on RTS were available for 149 patients, of whom 70% to 100% returned at a range of 8.3 to 16.9 months postoperatively, and 41.6% to 100% returned to the same or greater level of sports activity. The Tegner and Marx activity level scores ranged from 3 to 4 and from 5 to 11, respectively, at final follow-up.

CONCLUSION

Patients treated with DFO reported high rates of RTW and RTS, with most patients being able to return to recreational sport after surgery.

摘要

背景

股骨远端截骨术(DFO)是一种关节保护手术,可矫正膝内翻畸形和髌股外侧轨迹不良,从而恢复外侧胫股和髌股关节的运动学并减轻接触压力。

目的

通过文献系统回顾,评估 DFO 治疗外翻对线不良和外侧间室骨关节炎患者的重返工作岗位(RTW)和重返运动(RTS)的比率。

数据来源

使用 Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)指南对 PubMed、Cochrane 和 Embase 数据库进行了系统回顾。

研究选择

使用检索词“distal femoral osteotomy”AND“return to work”和“return to sport”进行搜索。排除了同时行全膝关节置换术的患者。

研究设计

系统回顾。

证据水平

4 级(4 级研究的系统回顾)。

数据提取

数据包括患者数量、年龄、性别、手术侧、随访时间、RTW 和 RTS 率、RTS 时间、返回时的活动水平以及活动水平评分(Tegner、Marx、Lysholm 和国际膝关节文献委员会)。使用非随机研究方法学指数(MINORS)标准评估偏倚风险。

结果

纳入了 7 篇文章共 194 名患者。平均年龄为 19 至 49 岁,平均术后随访时间为 36 至 90 个月。125 名患者的 RTW 数据可用,最终随访时 42.1%至 91.3%的患者返回工作岗位。149 名患者的 RTS 数据可用,术后 8.3 至 16.9 个月,70%至 100%的患者返回,运动水平相同或更高。最终随访时,Tegner 和 Marx 活动水平评分分别为 3 至 4 分和 5 至 11 分。

结论

接受 DFO 治疗的患者报告 RTW 和 RTS 率较高,大多数患者术后能够重返娱乐性运动。

相似文献

1
Return to Work and Sport After Distal Femoral Osteotomy: A Systematic Review.
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2
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本文引用的文献

2
Return to Sport following Isolated Lateral Opening Wedge Distal Femoral Osteotomy.
Cartilage. 2021 Dec;13(1_suppl):846S-852S. doi: 10.1177/1947603520924775. Epub 2020 May 25.
5
Distal femoral osteotomy in a young symptomatic population: Outcomes correlate to concomitant pathology.
J Orthop. 2019 May 3;16(3):283-288. doi: 10.1016/j.jor.2019.04.016. eCollection 2019 May-Jun.
7
Eight respectively nine out of ten patients return to sport and work after distal femoral osteotomy.
Knee Surg Sports Traumatol Arthrosc. 2019 Jul;27(7):2345-2353. doi: 10.1007/s00167-018-5206-x. Epub 2018 Oct 22.
8
The Effect of Lateral Opening Wedge Distal Femoral Varus Osteotomy on Tibiofemoral Contact Mechanics Through Knee Flexion.
Am J Sports Med. 2018 Nov;46(13):3237-3244. doi: 10.1177/0363546518799353. Epub 2018 Sep 28.
9
Combined distal femoral osteotomy (DFO) in genu valgum leads to reliable patellar stabilization and an improvement in knee function.
Knee Surg Sports Traumatol Arthrosc. 2018 Dec;26(12):3572-3581. doi: 10.1007/s00167-018-5000-9. Epub 2018 Jun 4.

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