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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 4/2023

Open Access 10-03-2022 | Knee Osteoarthritis | KNEE

Work intensity and quality of life can be restored following double-level osteotomy in varus knee osteoarthritis

Authors: Christoph Ihle, Julia Dorn, Atesch Ateschrang, Heiko Baumgartner, Moritz Herbst, Stefan Döbele, Tina Histing, Steffen Schröter, Marc-Daniel Ahrend

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 4/2023

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Abstract

Purpose

The purpose of this study was to assess changes in health-related quality of life (HRQL) and work intensity following double-level knee osteotomy (DLO). It was hypothesized that postoperative HRQL would be comparable to that of the general population and that work intensity can be restored in the short term.

Methods

Twenty-four patients (28 varus knees; mechanical tibiofemoral angle: −11.0 ± 3.0° (−6.0 to −17.0), age: 49.1 ± 9.5 (31–65) years) who underwent DLO were included. The duration the patients were unable to work was evaluated. HRQL was measured with the SF-36 questionnaire, which consists of a physical (PCS) and mental component summary score (MCS). The pre- to postoperative changes in the PCS and MCS were analysed. The PCS and MCS were also compared to those of the general population, who has a reference score value of 50 points. The work intensity measured with the REFA classification and the Tegner activity scale were assessed preoperatively and at the final postoperative follow-up examination (18.0 ± 10.0 (5–43) months).

Results

The duration that the patients were unable to work was 12.2 ± 4.4 (6–20) weeks. The PCS improved from 32.1 ± 11.3 (14.5–53.3) preoperatively to 54.6 ± 8.5 (25.2–63.7) (p < 0.001) at the final follow-up, and the MCS improved from 53.9 ± 11.1 (17.1–67.7) to 57.2 ± 3.1 (47.3–61.7) (n.s). The preoperative PCS was significantly lower than the reference score of the general population (p < 0.001), whereas the preoperative MCS was similar between the two groups (n.s.). At follow-up, no significant differences were observed between the PCS and the MCS of the patient group and those of the general population. Five patients who were unable to work prior to surgery due to knee symptoms returned to work with moderate (four patients) or even very heavy (one patient) workloads. The Tegner activity scale increased significantly from a median of 2.0 (0.0–5.0) to 4.0 (2.0–7.0) (p < 0.001).

Conclusion

Our results demonstrate an improvement in quality of life and return to working activity following DLO in the short term. The HRQL can be improved by DLO in patients with varus knee osteoarthritis to the level of the general population. These results can assist surgeons in discussing realistic expectations when considering patients for DLO.

Level of evidence

Study type: therapeutic, IV.
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Metadata
Title
Work intensity and quality of life can be restored following double-level osteotomy in varus knee osteoarthritis
Authors
Christoph Ihle
Julia Dorn
Atesch Ateschrang
Heiko Baumgartner
Moritz Herbst
Stefan Döbele
Tina Histing
Steffen Schröter
Marc-Daniel Ahrend
Publication date
10-03-2022
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 4/2023
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-022-06909-4

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