search for


Factors influencing return to sports after medial opening wedge high tibial osteotomy
Arthrosc Orthop Sports Med 2023;10:23-27
Published online May 1, 2023;
© 2023 Korean Arthroscopy Society and Korean Orthopedic Society for Sports Medicine.

Chan Jin Park, Chae-Jin Im, Hyun Ho Shin, Ji Hoon Choi, Jong-Keun Seon, Hong-Yeol Yang

Department of Orthopaedic Surgery, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
Correspondence to: Hong-Yeol Yang,
Department of Orthopaedic Surgery, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, 322 Seoyang-ro, Hwasun-eup, Hwasun 58128, Korea. Tel: +82-62-670-9475, Fax: +82-62-670-9476, E-mail:
Received March 27, 2023; Revised April 3, 2023; Accepted April 3, 2023.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: The ability to return to previous level of sports activity after medial opening wedge high tibial osteotomy (MOWHTO) is an important factor in surgical prognosis. However, little research has been conducted to determine what factors influence this.
Methods: A comparison was made between patients who were exercising at their previous level of daily exercise more than 2 years after MOWHTO and those who had not recovered to their previous level. Demographic data, preoperative and postoperative clinical scores, and radiological parameters were compared retrospectively to find significant differences. The clinical scores used were Knee Injury and Osteoarthritis Outcome Score, Tegner activity scale score, and Short-Form 36 questionnaire. The hip–knee–ankle angle, posterior tibial slope, and medial proximal tibial angle were used to compare radiological parameters.
Results: A total of 97 patients were enrolled in the study. Seventy-four patients returned to their previous level of sports activity, and 23 patients did not. There was a significant difference in gender among the demographic data. The preoperative and postoperative Tegner activity scale scores were significantly different among the clinical scores. Radiological parameters did not differ significantly between the two groups (P > 0.05).
Conclusion: In women, significantly more patients returned to previous sports activities. Additionally, higher preoperative and postoperative Tegner activity scale scores were associated with a lower rate of return to sports activities. This may help in predicting the return to sports activity after the MOWHTO.
Keywords : High tibial osteotomy; Knee osteoarthritis; Return to sport
  1. Kanakamedala AC, Hurley ET, Manjunath AK, Jazrawi LM, Alaia MJ, Strauss EJ. High tibial osteotomies for the treatment of osteoarthritis of the knee. JBJS Rev 2022;10:e21.00127.
    Pubmed CrossRef
  2. Koh IJ, Kim MW, Kim JH, Han SY, In Y. Trends in high tibial osteotomy and knee arthroplasty utilizations and demographics in Korea from 2009 to 2013. J Arthroplasty 2015;30:939-44.
    Pubmed CrossRef
  3. Bastard C, Mirouse G, Potage D, et al. Return to sports and quality of life after high tibial osteotomy in patients under 60 years of age. Orthop Traumatol Surg Res 2017;103:1189-91.
    Pubmed CrossRef
  4. Faschingbauer M, Nelitz M, Urlaub S, Reichel H, Dornacher D. Return to work and sporting activities after high tibial osteotomy. Int Orthop 2015;39:1527-34.
    Pubmed CrossRef
  5. Liu JN, Agarwalla A, Garcia GH, et al. Return to sport following isolated opening wedge high tibial osteotomy. Knee 2019;26:1306-12.
    Pubmed CrossRef
  6. Ruangsomboon P, Chareancholvanich K, Harnroongroj T, Pornrattanamaneewong C. Survivorship of medial opening wedge high tibial osteotomy in the elderly: two to ten years of follow up. Int Orthop 2017;41:2045-52.
    Pubmed CrossRef
  7. Ekhtiari S, Haldane CE, de Sa D, Simunovic N, Musahl V, Ayeni OR. Return to work and sport following high tibial osteotomy: a systematic review. J Bone Joint Surg Am 2016;98:1568-77.
    Pubmed CrossRef
  8. Jacquet C, Gulagaci F, Schmidt A, et al. Opening wedge high tibial osteotomy allows better outcomes than unicompartmental knee arthroplasty in patients expecting to return to impact sports. Knee Surg Sports Traumatol Arthrosc 2020;28:3849-57.
    Pubmed CrossRef
  9. Dugdale TW, Noyes FR, Styer D. Preoperative planning for high tibial osteotomy. The effect of lateral tibiofemoral separation and tibiofemoral length. Clin Orthop Relat Res 1992;(274):248-64.
  10. Fujisawa Y, Masuhara K, Shiomi S. The effect of high tibial osteotomy on osteoarthritis of the knee. An arthroscopic study of 54 knee joints. Orthop Clin North Am 1979;10:585-608.
    Pubmed CrossRef
  11. Roos EM, Roos HP, Lohmander LS, Ekdahl C, Beynnon BD. Knee injury and osteoarthritis outcome score (KOOS)--development of a self-administered outcome measure. J Orthop Sports Phys Ther 1998;28:88-96.
    Pubmed CrossRef
  12. Wright JM, Crockett HC, Slawski DP, Madsen MW, Windsor RE. High tibial osteotomy. J Am Acad Orthop Surg 2005;13:279-89.
    Pubmed CrossRef
  13. Tegner Y, Lysholm J. Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res 1985;(198):43-9.
  14. Katagiri H, Shioda M, Nakagawa Y, et al. Risk factors affecting return to sports and patient-reported outcomes after openingwedge high tibial osteotomy in active patients. Orthop J Sports Med 2022;10:23259671221118836.
    Pubmed KoreaMed CrossRef
  15. Cho HJ, Chang CB, Kim KW, et al. Gender and prevalence of knee osteoarthritis types in elderly Koreans. J Arthroplasty 2011; 26:994-9.
    Pubmed CrossRef

May 2024, 11 (1)