Return to Sport Activity in the Elderly Patients after Unicompartmental Knee Arthroplasty: A Systematic Review and Meta-Analysis

Papalia, Rocco; Zampogna, Biagio; Torre, Guglielmo; Balzani, Lorenzo Alirio Diaz; Vasta, Sebastiano; Papalia, Giuseppe Francesco; Vincentis, Antonio De; Denaro, Vincenzo

doi:10.3390/jcm9061756

Cited by 10 publications

(8 citation statements)

References 39 publications

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“…Several high-impact activities, including skiing and football, significantly decreased among participating patients [5]. Furthermore, UKA can be considered a winning choice in elderly active patients, as reported by Papalia et al and as confirmed in a recent systematic review in which the rate of return to sports in elderly patients after UKA was 86%, also showing a better relative return to sports and time taken to return for patients undergoing UKA compared with those undergoing TKA [26]. Higher rates of sport-specific return were observed for low-impact sports, whereas a full return to activities was prevented in high-impact sports.…”

Section: Discussionmentioning

confidence: 67%

Return to physical activity and change in body mass index after hypoallergenic medial mobile-bearing unicompartmental knee arthroplasty

et al. 2021

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Background The primary purpose of the present prospective study was to consecutively analyse the outcomes of the return to sports activity of patients with positive patch tests undergoing a medial mobile-bearing titanium niobium nitride (TiNbN) unicompartmental knee arthroplasty (UKA). The secondary purpose was to ascertain if a higher grade of physical activity leads to a reduction in the body mass index (BMI) of the patients. Material and methods Forty-one patients with positive skin patch tests were included in this prospective study. The clinical evaluation consisted of the University of California, Los Angeles (UCLA) activity scale and the High-Activity Arthroplasty Score (HAAS). Each patient was evaluated the day before surgery (T0), after 12.37 ± 0.70 months (T1), and on the day of the final follow-up, after 67.03 ± 18.2 months (T2). Furthermore, the BMI of each patient was analysed before surgery and during the final follow-up. Results The UCLA and HAAS mean preoperative values ranged from 3.68 ± 1.1.7 and 6.15 ± 0.76 to 6.1 ± 0.76 and 10.34 ± 1.3, respectively, at T1 (p < 0.0001) and to the final values of 6.34 ± 0.62 and 11.0 ± 8.9, respectively, at T2 (UCLA: T2 versus T1: p = 0.132; T2 versus T0: p < 0.0001; HAAS: T2 versus T1: p = 0.0027; T2 versus T0: p < 0.001). BMI ranged from a preoperative value of 27.97 ± 3.63 to a final value of 26.84 ± 3.11 (p < 0.0001). The only differences within the subgroups concerned patients with BMI ≥ 28, showing a superior HAAS at each follow-up (p < 0.05). A positive correlation was found between BMI and HAAS at T0 and T2 (p < 0.05). Conclusions This is the first study to evaluate the rate of the return to sports activities and change in BMI following hypoallergenic UKA. The majority of patients reduced their weight following UKA and improved their physical activity, showing outcomes that were comparable to the standard cobalt–chrome (CoCr) prostheses, regardless of gender, age, BMI and implant size. Level of evidence IV – Prospective Cohort Study. Trial registration researchregistry5978—Research Registry www.researchregistry.com

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Section: Discussionmentioning

confidence: 67%

Return to physical activity and change in body mass index after hypoallergenic medial mobile-bearing unicompartmental knee arthroplasty

et al. 2021

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“…In contrast, Kim et al reported that UKA had better short-term functional outcomes and return to recreational and sports activities than did HTO in patients with medial OA [ 20 ]. A systematic review and meta-analysis regarding RTS in elderly patients after UKA showed that higher return rates were observed for low-impact sports, whereas high-impact sports prevented a full return to activities [ 25 ]. Since there are risks of femoral component loosening and polyethylene wear in UKA [ 26 – 28 ], RTS after both surgical procedures needs to be assessed by long-term follow-up.…”

Section: Discussionmentioning

confidence: 99%

Return to sports activity after opening wedge high tibial osteotomy in patients aged 70 years and older

et al. 2021

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Background The purpose of this study was to evaluate return to sports (RTS) after opening wedge high tibial osteotomy (OWHTO) in elderly patients and associated factors affecting RTS. Methods Seventy-four patients (mean age 68 years) who underwent OWHTO were enrolled. Clinical outcomes were evaluated using the Knee Society Score (KSS). Patients were asked regarding types of sports activities and their levels of participation within preoperative 1 year and postoperative 1 year. Levels of participation in sports and recreational activities were examined using the Tegner activity scale. The outcomes were compared between two age groups (≥ 70 years vs. < 70 years). Results Of the 74 patients overall, 59 participated in at least one sport preoperatively, and 55 returned to sports postoperatively (RTS 93%). The KSS knee score and function score were significantly improved after surgery in both age groups (P < 0.05), but no significant differences were found between the age groups. The Tegner activity scales for ≥ 70 years and < 70 years were 2.9 ± 1.1 and 4.0 ± 1.9 preoperatively (P < 0.01) and 2.7 ± 1.2 and 3.3 ± 1.4 postoperatively (P = 0.16), respectively. RTS was reported by 24 of 25 (96.0%) in the age < 70 years group and 31 of 34 (91.2%) in the age ≥ 70 years group. Majority of age ≥ 70 years participated in low-impact sports preoperatively and returned to the same impact level postoperatively. Conclusions The rate of RTS after OWHTO was high in patients aged 70 years and older with low-impact level. OWHTO is a preferred surgical option for elderly patients who desire RTS.

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“…Arthroplasty is an alternative treatment option for knee OA in elderly patients. A systematic review and meta-analysis regarding RTS in elderly patients after UKA showed that higher return rates were observed for low-impact sports, whereas high-impact sports prevented a full return to activities [20]. Since there are risks of femoral component loosening and polyethylene wear in UKA [21][22][23], RTS after both surgical procedures needs to be assessed by long-term follow-up.…”

Section: Discussionmentioning

confidence: 99%

Return to Sports Activity After Opening Wedge High Tibial Osteotomy in Elderly Patients

Otoshi

Kumagai

Yamada

et al. 2021

Preprint

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Background: The purpose of this study was to evaluate return to sports (RTS) after opening wedge high tibial osteotomy (OWHTO) in elderly patients and associated factors affecting RTS.Methods: Seventy-four patients (mean age 68 years) who underwent OWHTO were enrolled. Clinical outcomes were evaluated using the Knee Society Score (KSS). Patients were asked regarding types of sports activities and their levels of participation within preoperative 1 year and postoperative 1 year. Levels of participation in sports and recreational activities were examined using the Tegner activity scale. The outcomes were compared between two age groups (≥70 years vs <70 years).Results: Of the 74 patients overall, 59 participated in at least one sport preoperatively, and 55 returned to sports postoperatively (RTS 93%). The KSS knee score and function score were significantly improved after surgery in both age groups (P<0.05), but no significant differences were found between the age groups. The Tegner activity scales for ≥70 years and <70 years were 2.9±1.1 and 4.0±1.9 preoperatively (P<0.01) and 2.7±1.2 and 3.3±1.4 postoperatively (P=0.16), respectively. RTS was reported by 24 of 25 (96.0%) in the age <70 years group and 31 of 34 (91.2%) in the age ≥70 years group. Of the patients who reported RTS, 66.7% in the age <70 years group and 77.4% in the age ≥70 years group could return to the same or higher level.Conclusions: The rate of RTS after OWHTO was high in elderly patients. OWHTO is a preferred surgical option for elderly patients who desire RTS.

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Return to Sport Activity in the Elderly Patients after Unicompartmental Knee Arthroplasty: A Systematic Review and Meta-Analysis

Cited by 10 publications

References 39 publications

Return to physical activity and change in body mass index after hypoallergenic medial mobile-bearing unicompartmental knee arthroplasty

Return to physical activity and change in body mass index after hypoallergenic medial mobile-bearing unicompartmental knee arthroplasty

Return to sports activity after opening wedge high tibial osteotomy in patients aged 70 years and older

Return to Sports Activity After Opening Wedge High Tibial Osteotomy in Elderly Patients

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