Knee realignment surgery lets athletes stay active

New research confirms that active people who undergo a procedure called high tibial osteotomy (HTO) to repair an arthritic knee will be just as active after the surgery.

Bowing of the leg due to arthritis on the inside of the knee joint is common among active people who sustain injuries to the cartilage or bone of the knee, Dr. Andreas Imhoff of Technische Universitaet Muenchen in Munich and colleagues note. When individuals with this injury are young, they add, joint replacement “may not provide sufficient longevity,” due to loosening or wear of the artificial joint or progression of arthritis.

These patients can undergo HTO to restore normal alignment of the joint, which can put off the need for knee replacement 5 to 10 years, Imhoff told Reuters Health. Thanks to new implant materials, he added, patients can bear weight on the leg immediately after surgery. Rehabilitation time is also much shorter than it is for some major knee operations including knee replacement surgery or anterior cruciate ligament (ACL) reconstruction, he added.

Several studies have looked at patients’ return to athletic activity after various types of knee surgery, Imhoff and his team explain in the American Journal of Sports Medicine, but only one small study followed up patients who had undergone HTO.

To investigate, they surveyed 65 HTO patients before and after the surgery. Before surgery, the researchers found, about 88 percent were taking part in sports and recreational activities, while afterwards, 91 percent were.

Both before and after surgery, study participants did their sport about twice a week, for a total of about four hours. Patients who had engaged in downhill skiing and mountain biking before the surgery continued to do so after the operation. All patients reported significantly less pain after having the surgery.

Based on the findings, Imhoff and his colleagues conclude: “High tibial osteotomy can therefore be considered a clinically successful procedure that allows the active patient with beginning osteoarthritis of the knee to return to regular and sustained sporting activities.”

SOURCE: American Journal of Sports Medicine, February 2009.

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