Return to Work Following High Tibial Osteotomy With Concomitant Osteochondral Allograft Transplantation

Purpose: To assess the timeline of return to work (RTW) following opening-wedge high tibial osteotomy (HTO) with concomitant osteochondral allograft transplantation (OCA) of the medial femoral condyle. Methods: Consecutive patients undergoing HTO + OCA due to focal chondral deficiency and varus deformity were retrospectively identified and reviewed at a minimum of 2 years following surgery. Patients completed a subjective work questionnaire, a visual analog scale for pain, Single Assessment Numerical Evaluation, and a satisfaction questionnaire. Results: Twenty-eight patients (average age: 36.0 +/- 7.9 years) were included at 6.7 +/- 4.1 years postoperatively. Twenty-six patients were employed before surgery and 25 patients (96.2%) returned to work following HTO + OCA. However, only 88.5% of patients were able to return to the same level of occupational intensity by 3.5 +/- 2.9 months postoperatively. The rate of RTW to the same occupational intensity for sedentary, light, medium, and heavy intensity occupations was 100%, 100%, 88.9%, and 80% (P = .8), whereas the duration of RTW was 9.0 +/- 7.1 months, 1.7 +/- 1.4 months, 2.7 +/- 0.9 months, and 4.2 +/- 1.9 months (P = .006), respectively. Two patients (7.7%) underwent knee replacement by 5.3 +/- 3.1 years postoperatively due to progression of osteoarthritis in the medial compartment. Conclusions: In patients with focal chondral deficiency and varus deformity, HTO + OCA provides a high rate of RTW (96.2%) by 3.5 +/- 2.9 months postoperatively. However, patients with greater-intensity occupations may take longer to return to work than those with less physically demanding occupations.