Late Breaking News
Return to Active Duty Unusual After Knee Procedure
CHICAGO - Treating large cartilage knee defects with an allograft osteoarticular transplant (OATS) does not allow most military personnel to return to full active duty status, according to research presented recently at the American Orthopaedic Society for Sports Medicine's Specialty Day.1
“Only 28.9% of the military patients we studied were able to return to full duty, when they received the OATS procedure with only 5.3% returning to their pre-injury level of activity,” said James S. Shaha, MD of Tripler Army Medical Center in Hawaii. “It appears the branch of service also was a significant predictor of outcome, with Marines and Navy service members more likely to return to full activity.”
Restoring cartilage can relieve pain and allow better function, but surgery also is often performed to delay or prevent the onset of arthritis in the injured joint.
For the study, researchers performed a retrospective review on 38 OATS procedures performed at a single military institution by four sports medicine fellowship-trained orthopedic surgeons between January 2002 and August 2011. All patients were active duty at the time of the index operation.
Data was collected on demographics, return to duty, the Knee Injury and Osteoarthritis Outcome Score and ultimate effect on military duty. A successful endpoint was defined as ability to return to pre-injury military occupation specialty with no restrictions.
Though the procedure was shown to diminish pain and improve function in some patients, it did not completely resolve the issues for the active patient. In fact, more than 40% of the patients in this study were “boarded out” of the military because of this condition.
“Cartilage injuries in the high-demand, athletic population remain a clinical challenge. Our study contrasts recent literature which suggests a high rate of return after the OATS procedure and further demonstrates that physicians must carefully interpret what ‘return to activity’ means to different populations,” Shaha said.
1. Shaha JS, Cook JB, Bottoni C, Rowles DJ, et. al. “Return to an Athletic Lifestyle Following Osteochondral Allograft Transplantation of the Knee.” American Orthopaedic Society for Sports Medicine Specialty Day (March 23, 2013)