ArticleThe American journal of sports medicine2019
Prognostic Factors for Return to Sport After High Tibial Osteotomy: A Directed Acyclic Graph Approach.
Article in The American journal of sports medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 43 citations in OpenAlex.
- Directed acyclic graphs in perioperative observational research-A systematic review and critique against best practice recommendations.PloS one · 2023Pooled it
- How to choose treatment for patients who are eligible for both unicompartmental knee arthroplasty and high tibial osteotomy?Journal of orthopaedic translation · 2026Review
- Article
- Preoperative activity, postoperative flexion contractures, and degree of medial cartilage damage affects achievement of high physical activity after open wedge high tibial osteotomy.Journal of experimental orthopaedics · 2025Article
- RETURN TO SPORTS FOLLOWING KNEE OSTEOTOMY IN COMPETITIVE ATHLETES - CASE SERIES.Acta ortopedica brasileira · 2025Article
- Return to Duty in Military Servicemembers After High Tibial Osteotomy Not Associated With Preoperative Radiographic Parameters : A Retrospective Analysis.Orthopaedic journal of sports medicine · 2024Article
- High tibial osteotomy versus unicompartmental knee arthroplasty for Kellgren-Lawrence grade 3-4 knee osteoarthritis in younger patients: comparable improvements in patient-reported outcomes, adjusted for osteoarthritis grade and sex.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Assessment of return to sport and functional outcomes following distal femoral, double level and high tibial osteotomies for active patients with symptomatic varus malalignment.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Favorable rates of return to activity and work following lateral closing wedge distal femoral osteotomy for femoral-based symptomatic varus malalignment: an analysis at a mean 6-year follow-up.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Good clinical outcomes and return to sports after hybrid closed-wedge high tibial osteotomy.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Risk Factors Affecting Return to Sports and Patient-Reported Outcomes After Opening-Wedge High Tibial Osteotomy in Active Patients.Orthopaedic journal of sports medicine · 2022Article
- Patients return to sports and to work after successful treatment of septic arthritis following anterior cruciate ligament reconstruction.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2022Article
- Return to Sport and Work Following Distal Femoral Varus Osteotomy: A Systematic Review.HSS journal : the musculoskeletal journal of Hospital for Special Surgery · 2022Review
- Differences in the Demographics and Preferred Management of Knee Cartilage Injuries in Soccer Players Across FIFA Centers of Excellence.Cartilage · 2021Article
- Return to sports activity after opening wedge high tibial osteotomy in patients aged 70 years and older.Journal of orthopaedic surgery and research · 2021Article
- The difficulty of continuing sports activities after open-wedge high tibial osteotomy in patient with medial knee osteoarthritis: a retrospective case series at 2-year-minimum follow-up.Journal of experimental orthopaedics · 2021Article
- Opening wedge high tibial osteotomy allows better outcomes than unicompartmental knee arthroplasty in patients expecting to return to impact sports.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2020Article
- Comparable Outcomes and Implant Survivorship of Total Knee Arthroplasty After High Tibial Osteotomy and Primary Arthroplasty: A Matched Cohort Study.JB & JS open accessArticle
Corrections and comments
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Authors and funding
7 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHigh tibial osteotomy (HTO) is increasingly used in young and physically active patients with knee osteoarthritis. These patients have high expectations, including return to sport (RTS). By retaining native knee structures, a return to highly knee-demanding activities seems possible. However, evidence on patient-related outcomes, including RTS, is sparse. Also, time to RTS has never been described. Furthermore, prognostic factors for RTS after HTO have never been investigated. These data may further justify HTO as a surgical alternative to knee arthroplasty. PURPOSE: To investigate the extent and timing of RTS after HTO in the largest cohort investigated for RTS to date and to identify prognostic factors for successful RTS. STUDY
designCase-control study; Level of evidence, 3.
methodsConsecutive patients with HTO, operated on between 2012 and 2015, received a questionnaire. First, pre- and postoperative sports participation questions were asked. Also, time to RTS, sports level and frequency, impact level, the presymptomatic and postoperative Tegner activity score (1-10; higher is more active), and the postoperative Lysholm score (0-100; higher is better) were collected. Finally, prognostic factors for RTS were analyzed using a logistic regression model. Covariates were selected based on univariate analysis and a directed acyclic graph.
resultsWe included 340 eligible patients of whom 294 sufficiently completed the questionnaire. The mean follow-up was 3.7 years (± 1.0 years). Out of 256 patients participating in sports preoperatively, 210 patients (82%) returned to sport postoperatively, of whom 158 (75%) returned within 6 months. We observed a shift to participation in lower-impact activities, although 44% of reported sports activities at final follow-up were intermediate- or high-impact sports. The median Tegner score decreased from 5.0 (interquartile range [IQR], 4.0-6.0) presymptomatically to 4.0 (IQR, 3.0-4.0) at follow-up (
conclusionMore than 8 of 10 patients returned to sport after HTO. Continued preoperative sports participation was associated with a successful RTS. Future studies need to identify additional prognostic factors.
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