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Realignment osteotomy of the knee allows for return to work and sport activities in the young athletic population
  1. Suzanne Witjes1,2,3,4,5,
  2. Stacey Wanlin1,
  3. Robert Litchfield1,
  4. Rutger C I van Geenen2,
  5. Gino M M J Kerkhoffs3,4,5,
  6. Alan Getgood1
    1. 1 Fowler Kennedy Sport Medicine Clinic, University of Western Ontario, London, Ontario, Canada
    2. 2 Department of Orthopaedic Surgery, Foundation FORCE (Foundation for Orthopaedic Research Care Education), Amphia Hospital, Breda, The Netherlands
    3. 3 Department of Orthopaedic Surgery, Academic Medical Center, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
    4. 4 ACES (Academic Center for Evidence-Based Sports Medicine), Amsterdam, The Netherlands
    5. 5 ACHSS (Amsterdam Collaboration for Health and Safety in Sports), Amsterdam, The Netherlands
    1. Correspondence to Suzanne Witjes, Fowler Kennedy Sport Medicine Clinic, University of Western Ontario, London, ON N6A 3K7, Canada; suzanne.witjes{at}


    Objective To evaluate return to work and sport rates of young athletic patients following knee osteotomy, including the highest level of sports participation and satisfaction with activities.

    Methods We performed a cross-sectional study of patients of age 45 years or younger who underwent realignment osteotomy of the knee between 2005 and 2015. Data concerning work activities, sports participation and satisfaction were collected by a survey including the modified Naal and Weiss questionnaires, Numeric Rating Scale (NRS) of satisfaction and Net Promoter Score (NPS).

    Results Analysis of data from 60 patients with a median age of 38 (15–45) was performed. Of those 60 patients, 95% returned to sports following surgery, of whom 74% could return to their main preinjury sport or to a different sport of higher impact. The main preoperative sport types involved 65% high-impact, 23% intermediate-impact and 12% low-impact activities. The highest level of sport participation preoperatively was 13% professional, 7% varsity and 80% amateur (58% competitive, 42% recreational). Postoperatively 5% returned to professional level, 4% varsity and 91% amateur (14% competitive, 86% recreational), and at follow-up 22% of patients had retired from sports. At follow-up 88% of patients were still working, with 61% at the same activity level and 12% at a higher level than before surgery. The median NRS satisfaction score with activities in general was 6 (0–10), and with activities of daily living, work and leisure time 9 (0–10), 7 (0–10) and 6 (0–10), respectively. The main reasons for dissatisfaction were persisting knee pain (67%) and lack of range of motion (29%). The NPS was 14, indicating that patients would recommend the surgery to friends or family.

    Conclusion Young athletes can return to work and sport activities following realignment osteotomy of the knee. Although their levels of sports participation significantly decreased and satisfaction with their activity level was limited, we disagree with the opinion that a knee osteotomy directly leads to the end of an athlete’s sporting career.

    Level of evidence Level III, prospective cohort study.

    • knee
    • Osteotomy
    • osteoarthritis
    • cartilage
    • ligament

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    • Contributors SWi: study conception and design, data collection, data analysis, and drafting and revision of the manuscript. SWa: data acquisition and final approval of the manuscript. RL: provision of patient data, revision of study design and final approval of the manuscript. GMMJK and RCIvG: approval of study design, and revision and final approval of the manuscript. AG: study design, provision of patient data, data interpretation, revision of the manuscript and final approval.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Not required.

    • Ethics approval The study was approved by the Research Ethics Board for Health Sciences Research Involving Human Subjects of our university.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement This manuscript contains original material that has been presented during the 11th Biennial ISAKOS Congress in Shanghai, but has not been published previously and is not under consideration elsewhere. There are no additional unpublished data available other than those mentioned in this manuscript.

    • Collaborators Kevin Willits.

    • Presented at Submitted as the winner of the John J Joyce Award, second place, Shanghai, 2017.

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