{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T10:32:07Z","timestamp":1788258727273,"version":"build-2803163510"},"reference-count":42,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,3,10]],"date-time":"2022-03-10T00:00:00Z","timestamp":1646870400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2022,3,10]],"date-time":"2022-03-10T00:00:00Z","timestamp":1646870400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,3,10]],"date-time":"2022-03-10T00:00:00Z","timestamp":1646870400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100002345","name":"Eberhard Karls Universit\u00e4t T\u00fcbingen","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002345","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100009397","name":"Medizinischen Fakult\u00e4t, Eberhard Karls Universit\u00e4t T\u00fcbingen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009397","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The purpose of this study was to assess changes in health\u2010related quality of life (HRQL) and work intensity following double\u2010level knee osteotomy (DLO). It was hypothesized that postoperative HRQL would be comparable to that of the general population and that work intensity can be restored in the short term.\n<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty\u2010four patients (28 varus knees; mechanical tibiofemoral angle: \u221211.0\u2009\u00b1\u20093.0\u00b0 (\u22126.0 to \u221217.0), age: 49.1\u2009\u00b1\u20099.5 (31\u201365) years) who underwent DLO were included. The duration the patients were unable to work was evaluated. HRQL was measured with the SF\u201036 questionnaire, which consists of a physical (PCS) and mental component summary score (MCS). The pre\u2010 to postoperative changes in the PCS and MCS were analysed. The PCS and MCS were also compared to those of the general population, who has a reference score value of 50 points. The work intensity measured with the REFA classification and the Tegner activity scale were assessed preoperatively and at the final postoperative follow\u2010up examination (18.0\u2009\u00b1\u200910.0 (5\u201343) months).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The duration that the patients were unable to work was 12.2\u2009\u00b1\u20094.4 (6\u201320) weeks. The PCS improved from 32.1\u2009\u00b1\u200911.3 (14.5\u201353.3) preoperatively to 54.6\u2009\u00b1\u20098.5 (25.2\u201363.7) (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) at the final follow\u2010up, and the MCS improved from 53.9\u2009\u00b1\u200911.1 (17.1\u201367.7) to 57.2\u2009\u00b1\u20093.1 (47.3\u201361.7) (n.s). The preoperative PCS was significantly lower than the reference score of the general population (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), whereas the preoperative MCS was similar between the two groups (n.s<jats:italic>.<\/jats:italic>). At follow\u2010up, no significant differences were observed between the PCS and the MCS of the patient group and those of the general population. Five patients who were unable to work prior to surgery due to knee symptoms returned to work with moderate (four patients) or even very heavy (one patient) workloads. The Tegner activity scale increased significantly from a median of 2.0 (0.0\u20135.0) to 4.0 (2.0\u20137.0) (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our results demonstrate an improvement in quality of life and return to working activity following DLO in the short term. The HRQL can be improved by DLO in patients with varus knee osteoarthritis to the level of the general population. These results can assist surgeons in discussing realistic expectations when considering patients for DLO.\n<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>Study type: therapeutic, IV.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-022-06909-4","type":"journal-article","created":{"date-parts":[[2022,3,10]],"date-time":"2022-03-10T07:03:32Z","timestamp":1646895812000},"page":"1546-1555","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Work intensity and quality of life can be restored following double\u2010level osteotomy in varus knee osteoarthritis"],"prefix":"10.1002","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0752-1266","authenticated-orcid":false,"given":"Christoph","family":"Ihle","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Traumatology and Reconstructive Surgery, BG Trauma Center T\u00fcbingen Eberhard Karls University T\u00fcbingen T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Dorn","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Traumatology and Reconstructive Surgery, BG Trauma Center T\u00fcbingen Eberhard Karls University T\u00fcbingen T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atesch","family":"Ateschrang","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Evangelisches Stift St. Martin Gemeinschaftsklinikum Mittelrhein Koblenz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heiko","family":"Baumgartner","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Traumatology and Reconstructive Surgery, BG Trauma Center T\u00fcbingen Eberhard Karls University T\u00fcbingen T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moritz","family":"Herbst","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Traumatology and Reconstructive Surgery, BG Trauma Center T\u00fcbingen Eberhard Karls University T\u00fcbingen T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"D\u00f6bele","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Traumatology and Reconstructive Surgery, BG Trauma Center T\u00fcbingen Eberhard Karls University T\u00fcbingen T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tina","family":"Histing","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Traumatology and Reconstructive Surgery, BG Trauma Center T\u00fcbingen Eberhard Karls University T\u00fcbingen T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steffen","family":"Schr\u00f6ter","sequence":"additional","affiliation":[{"name":"<!--<label>3<\/label>--> Komitee Osteotomie der Deutschen Kniegesellschaft (DKG) Munich Germany"},{"name":"<!--<label>4<\/label>--> Department of Traumatology and Reconstructive Surgery Diakonie Klinikum GmbH Jung\u2010Stilling\u2010Krankenhaus Siegen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc\u2010Daniel","family":"Ahrend","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Traumatology and Reconstructive Surgery, BG Trauma Center T\u00fcbingen Eberhard Karls University T\u00fcbingen T\u00fcbingen Germany"},{"name":"<!--<label>3<\/label>--> Komitee Osteotomie der Deutschen Kniegesellschaft (DKG) Munich Germany"},{"name":"<!--<label>5<\/label>--> AO Research Institute Davos Davos 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October 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 January 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 March 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"SS is a member of the AO Joint Preservation and Osteotomy Expert Group. All other authors declare no potential conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study was approved by the local ethics committee of the University of T\u00fcbingen (103\/2013BO2).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was provided by all patients included into the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}