This study evaluated return to sport (RTS), activity level, and return to work (RTW) in young, physically active patients who underwent isolated distal femoral osteotomy (DFO) to treat lateral knee pain associated with valgus malalignment. Thirty-four patients were assessed at a mean follow-up of more than seven years to determine the long-term impact of the procedure on sports participation and occupational outcomes.

The findings showed that nearly 80% of patients successfully returned to sports, typically within five months after surgery, and most maintained their pre-symptom level of athletic activity. Two-thirds of the cohort remained regularly active at long-term follow-up. All patients returned to work, with the majority resuming jobs requiring similar physical demands as before surgery. A higher pre-symptom activity level was identified as a significant predictor of successful return to sport, while the overall complication rate remained low and no clinical failures were reported.

These results suggest that distal femoral osteotomy is an effective joint-preserving procedure for young, active patients, enabling high rates of return to sport and work with sustained functional outcomes over the long term.