Successful return to sport following distal femoral osteotomy and lateral unicompartmental knee arthroplasty for isolated lateral knee osteoarthritis: A systematic review and meta-analysis.
Gaby V Ten Noever de Brauw, Lindsey V Ruderman, Roderick J M Vossen, Inger N Sierevelt, Jelle P van der List, Gino M M J Kerkhoffs, Hendrik A Zuiderbaan
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引用次数: 0
Abstract
Purpose: To evaluate: (i) return to sport (RTS) rates following distal femoral osteotomy (DFO) and lateral unicompartmental knee arthroplasty (UKA), including the likelihood of returning to pre-arthritic or higher levels of performance; (ii) participation in low-, intermediate- and high-impact sports pre- and postoperatively; and (iii) the ability of athletes to resume sporting activities at a professional or competitive level.
Methods: A systematic literature search was conducted in PubMed, Embase and the Cochrane Library up to 17 June 2025. Studies were eligible if they focused on symptomatic lateral unicompartmental knee osteoarthritis as the primary indication and provided data on RTS outcomes. Outcomes of interest included RTS and return to performance (RTP) rates, sport participation categorized by impact level, return to play rates and sports-related patient-reported outcome measures. Random-effects models were utilized to evaluate RTS and RTP outcomes.
Results: Nine non-comparative studies (256 patients) were included. Five on DFO (127 patients; mean age 40.1 ± 13.3 years; mean follow-up 90.4 ± 72.3 months) and four on lateral UKA (125 patients; mean age 58.0 ± 8.8 years; mean follow-up 39.1 ± 16.2 months). Most studies provided Level IV Evidence and moderate quality (Methodological Index for Non-Randomized Studies score: 8-10). Random effect models provided RTS rates of 89.7% (95% confidence interval [CI]: 76.9-95.8) for DFO and 92.4% (95% CI: 81.5-97.1) for lateral UKA. RTP rates were 62.7% (95% CI: 41.1-80.2) and 88.5% (95% CI: 75.1-95.1), respectively. High-impact sport participation decreased after lateral UKA (11.5% to 3.4%), while remaining relatively stable following DFO (32.8% to 28.0%). Competitive-level athletes achieved a 100% RTS rate following DFO.
Conclusions: Both DFO and lateral UKA are associated with high rates of RTS. However, lateral UKA often leads to a transition from high-impact to lower-impact activities. Clinicians can leverage these findings to optimize patient counselling and align postoperative RTS expectations with functional outcomes.
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