Return to Sport and Outcomes After Concomitant Lateral Meniscal Allograft Transplant and Distal Femoral Varus Osteotomy

Puzzitiello, Richard N.; Liu, Joseph N.; Garcia, Grant H.; Redondo, Michael L.; Christian, David R.; Yanke, Adam B.; Cole, Brian J.

doi:10.1016/j.arthro.2019.07.022

Cited by 19 publications

(37 citation statements)

References 38 publications

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“…After applying inclusion and exclusion criteria, we identified 7 studies that were eligible for this review ( Fig. 1 ) [ 1 , 2 , 11 , 41 – 43 , 55 ].…”

Section: Resultsmentioning

confidence: 99%

“…The average follow-up was 5.5 ± 1.9 years. Five studies reported RTS rates with a mean age of 33.8 ± 11.3 years and men comprising 39.5% ± 14.4% of study samples [ 1 , 2 , 11 , 41 , 55 ]. Four studies used the lateral opening-wedge technique [ 1 , 2 , 41 , 42 ], 1 study used the wedgeless V-shaped technique [ 11 ], and 2 studies used a combination of both the lateral opening-wedge and medial closing-wedge technique [ 43 , 55 ].…”

Section: Resultsmentioning

confidence: 99%

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Return to Sport and Work Following Distal Femoral Varus Osteotomy: A Systematic Review

Khalik

Lameire

Rubinger

et al. 2021

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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Background: Distal femoral varus osteotomy (DFVO) is an effective surgical intervention for the management of symptomatic valgus malalignment of the knee. Because it preserves the native knee joint and its ligamentous stability, DFVO is preferred to total knee arthroplasty (TKA) in the young, active population. Purpose: We sought to assess return to work (RTW) and return to sport (RTS) rates following DFVO for valgus malalignment of the knee. Methods: For this systematic review, we searched EMBASE, MEDLINE, and Web of Science from inception through December 31, 2020. English language studies of all levels of evidence explicitly reporting on RTS and RTW rates following DFVO for valgus malalignment of the knee were eligible for inclusion. Results: Seven studies and 127 patients were included in our analysis. Mean age was 32.4 ± 8.8 years with men comprising 46.7% ± 22.3% of study populations. The mean RTS rate was 87.2% ± 10.7%, with a return to preoperative activity levels rate of 65.4% ± 26.8%. The mean RTW rate was 81.8% ± 23.3%, with a return to preoperative activity levels of 72.8% ± 18.1%. The mean reoperation rate was 35.6% ± 18.8% within a mean follow-up period of 5.5 ± 1.9 years. Conclusions: This systematic review of low-level studies found DFVO to be a safe and effective procedure for the management of genu valgum in young, active populations, with most patients returning to sport and/or work, although not all at their preoperative activity levels. A paucity of data surrounds RTS and RTW rates following DFVO. Future studies should explicitly report both return to activity rates and whether patients returned to their preoperative activity levels.

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“…After applying inclusion and exclusion criteria, we identified 7 studies that were eligible for this review ( Fig. 1 ) [ 1 , 2 , 11 , 41 – 43 , 55 ].…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Return to Sport and Work Following Distal Femoral Varus Osteotomy: A Systematic Review

Khalik

Lameire

Rubinger

et al. 2021

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

View full text Add to dashboard Cite

show abstract

“…They have taken a young cohort of patients (average age, 23 years) and have restored function and longevity to their knees, and it would appear that there have been few complications. I also commend Puzzitiello et al 1 for honestly reporting these results and being somewhat critical of themselves in listing the limitations of this study.…”

Section: See Related Article On Page 253mentioning

confidence: 88%

“…It is recognized that some individuals may wish to return to high-level sports as professional athletes, but these cases are the exceptions and I do not believe this should be promoted as routine practice. I hope Puzzitiello et al 1 will continue to follow up and report on this young cohort of patients and thus be more able to fully answer the question of whether returning to sporting activity is advisable after such difficult surgery rather than simply reporting that it is possible.…”

Section: See Related Article On Page 253mentioning

confidence: 96%

“…My concern is that I fear the wrong message is being promoted on this very serious problem and that the reader may easily take away the impression that this is an operation recommended to allow patients to return to sport. Indeed, in the Discussion section, Puzzitiello et al 1 family life without pain or disability. The second goal is to significantly delay the progression to arthritis and thus the need for knee arthroplasty.…”

Section: See Related Article On Page 253mentioning

confidence: 99%

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Editorial Commentary: Meniscus Message—What Is Possible or What Is Advisable?

Myers

2020

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Distal femoral varus osteotomy combined with meniscal allograft transplantation is a major surgical undertaking, not without risk and not to be taken on lightly by either the surgeon or the patient. It really is a salvage operation for a knee that is deteriorating and heading for arthroplasty at some future point. It is not an operation that should be offered to patients to allow them to return to sport. The fact that some patients do return to sport is good and is a credit to the operation and the patient's tenacity with rehabilitation, but we must question the rationale of such activity, which will most likely hasten the demise of the joint.

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Meniscal allograft transplantation: A matched‐pair analysis reveals worse sport activity level but similar clinical improvement and survival in women compared to men

Romandini,

Lucidi,

Altovino

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeThe aim of this study was to assess how gender might affect the clinical outcome and survival of meniscal allograft transplantation (MAT).MethodsA total of 358 patients (23.2% women, 76.8% men) were treated with fresh‐frozen nonirradiated allografts implantated arthroscopically using a single‐ or double‐tunnel technique without bone plugs and peripheral suture to the capsule with ‘all‐inside’ stitches.ResultsPatients were evaluated at baseline and 2‐year follow‐up with the Lysholm score, visual analogue scale (VAS) pain, the Knee Osteoarthritis Outcome Score (KOOS) subscales and Tegner score. Women presented higher body mass index (p < 0.0005), poorer baseline VAS (p = 0.012), Lysholm score (p = 0.005), KOOS symptom (p = 0.034) and KOOS pain (p = 0.030), Tegner score (preinjury and basal, p < 0.0001 and p = 0.002, respectively), a lower number of previous (p = 0.039) and concurrent (p = 0.001) anterior cruciate ligament reconstructions and a higher number of concurrent procedures (p = 0.032) and distal femoral osteotomies (p = 0.024). Worse results were documented in women at 2 years, with lower Lysholm score (p = 0.024) and Tegner score (p = 0.007) and a lower clinical survival rate (p = 0.03) (67.5% vs. 82.2%) in the overall patient cohort. However, the matched‐pair analysis only confirmed a lower Tegner score value at 2 years (p = 0.016), while underlying the interplay of sex, age and concomitant cartilage lesions in determining the clinical outcome. The analysis of this large series of patients affected by postmeniscectomy syndrome and treated with MAT revealed gender differences.ConclusionWhile both genders benefited from a significant improvement, the female population presents more often with older age, concomitant cartilage lesions and a lower activity level, all factors contributing towards a lower clinical success after MAT.Level of EvidenceLevel III, comparative study.

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Return to Sport and Outcomes After Concomitant Lateral Meniscal Allograft Transplant and Distal Femoral Varus Osteotomy

Cited by 19 publications

References 38 publications

Return to Sport and Work Following Distal Femoral Varus Osteotomy: A Systematic Review

Return to Sport and Work Following Distal Femoral Varus Osteotomy: A Systematic Review

Editorial Commentary: Meniscus Message—What Is Possible or What Is Advisable?

Meniscal allograft transplantation: A matched‐pair analysis reveals worse sport activity level but similar clinical improvement and survival in women compared to men

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