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. 2020 Dec 3;8(12):2325967120965966.
doi: 10.1177/2325967120965966. eCollection 2020 Dec.

Return to Work After Distal Femoral Varus Osteotomy

Richard N Puzzitiello  1 , Joseph N Liu  2 , Grant H Garcia  3 , Michael L Redondo  4 , Enrico M Forlenza  5 , Avinesh Agarwalla  6 , Adam B Yanke  6 , Brian J Cole  6
Affiliations

Return to Work After Distal Femoral Varus Osteotomy

Richard N Puzzitiello et al. Orthop J Sports Med. .

Abstract

Background: Distal femoral varus osteotomy (DFVO) is a well-described procedure to address valgus deformity of the knee. There is a paucity of information available regarding patients' ability to return to work (RTW) after DFVO.

Purpose: To report the objective findings for RTW rates and times for patients receiving a DFVO for lateral compartment osteoarthritis secondary to valgus deformity of the knee.

Study design: Cohort study; Level of evidence, 3.

Methods: This was a retrospective study of patients who received a lateral-wedge opening DFVO. Patients must have worked within 3 years before their operation to be included for analysis. Patients were contacted at a minimum of 2 years postoperatively for interview and questionnaire evaluation, including a subjective work questionnaire, visual analog scale (VAS) for pain, Single Assessment Numerical Evaluation (SANE), and a satisfaction questionnaire.

Results: Overall, 32 patients were contacted at a mean follow-up of 7.1 ± 4.1 years (range, 2.2-13.3 years). The mean ± SD age at the time of surgery was 30.8 ± 8.8 years (range, 17.2-46.5 years), and 65.6% of patients were female. Eleven patients (34.4%) received a concomitant meniscal allograft transplant, and 12 (37.5%) received a cartilage grafting procedure. The average VAS pain score decreased significantly from 6.1 preoperatively to 3.2 postoperatively (P = .03). All patients were able to RTW, at a mean time of 6.0 ± 13.2 months postoperatively (range, 0-72 months). When stratified by work intensity, the average time to return was 13.8, 3.1, 2.7, and 2.9 months for high, moderate, light, and sedentary occupations, respectively. There was no significant difference between these RTW times (P = .16), although this analysis may have been limited by the small sample size. Four patients whose work was classified as heavy work (50%) and 3 whose work was classified as moderate work (18.8%) either switched jobs or kept the same job with lighter physical duties as a result of their procedures.

Conclusion: In a young and active population, DFVO for valgus deformity reliably afforded the ability to RTW within a relatively short time for patients with sedentary, light, and moderate occupational demands. However, patients with moderate- to high-intensity occupational demands may be unable to RTW at their preoperative level.

Keywords: distal femoral osteotomy (DFO); distal femoral valgus osteotomy (DFVO); meniscal allograft transplant (MAT); patient-reported outcomes; return to work.

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Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: J.N.L. has received educational support from Arthrex and Smith & Nephew and hospitality payments from Exactech and Wright Medical. G.H.G. has received educational support from Arthrex and Smith & Nephew and hospitality payments from Wright Medical. A.B.Y. has received research support from Arthrex, Organogenesis, and Vericel; educational support from Smith & Nephew and Arthrex; and consulting fees from Aastrom Biosciences, JRF Ortho, Olympus, Patient IQ, Smith & Nephew, and Sparta Biomedical. B.J.C. has received research support from Aesculap/B.Braun, Arthrex, and Regentis; educational support from Medwest; consulting fees from Acumed, Anika Therapeutics, Arthrex, Bioventus, Flexion Therapeutics, Geistlich Pharma, Regentis, Smith & Nephew, Vericel, and Zimmer Biomet; speaking fees from Arthrex and Lifenet Health; hospitality payments from GE Healthcare; honoraria from Vericel; other financial or material support from Athletico and JRF Ortho; and royalties from Arthrex, DJO, Elsevier, and Operative Techniques in Sports Medicine; and has stock/stock options in Bandgrip, Ossio, and Regentis. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

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