Prognostic factors and return to sport rates after medial opening wedge high tibial osteotomy: systematic review
DOI:
https://doi.org/10.58814/01208845.741Keywords:
Osteotomy, Return to Sport, Prognosis, Knee Osteoarthritis, Systematic ReviewAbstract
Introduction: Medial opening wedge high tibial osteotomy is a joint-preserving procedure for active patients with medial unicompartmental knee osteoarthritis. Return to sport is a key outcome, but reported return-to-sport rates are heterogeneous and the prognostic factors remain poorly defined.
Objective: To synthesize the evidence on return-to-sport rates and prognostic factors in adults with medial unicompartmental knee osteoarthritis and varus deformity.
Methodology: A systematic search was conducted from January 2009 to June 2025 in accordance with the PRISMA 2020 and the CHARMS framework. Methodological quality was assessed using the QUIPS. Data were synthesized using a structured narrative synthesis, and the certainty was assessed using the GRADE approach for prognosis.
Results: Eleven studies (859 patients) were included. The rate of return to any level of sporting activity ranged from 73.9% to 88.6%, whereas return to the same preoperative level of sport was less frequent and more variable (34.6% to 50.0%). The mean time to return ranged from five to nine months. The prognostic factor with the strongest evidence was the preoperative level of sporting activity. Age, body mass index, and sex showed no consistent association. The certainty was low to very low for all prognostic factors.
Conclusions: Medial opening wedge high tibial osteotomy is associated with high rates of return to sporting activity, while return to the same preoperative level is less common. The evidence is of low certainty, and preoperative counseling should be undertaken with caution. Further prospective studies are needed.
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