Patient-reported outcomes correlate with functional scores after opening-wedge high tibial osteotomy: a clinical study
- 207 Downloads
The purpose of this study was to assess post-operative patient subjective satisfaction and to analyze associated peri-operative factors following biplanar medial open wedge high tibial osteotomy (OWHTO).
The study cohort consisted of 88 patients with a minimum of two years of follow-up. Patient satisfaction was evaluated with a questionnaire that assessed (1) overall satisfaction, (2) pain relief, (3) daily living functions, and (4) cosmesis. Patients were categorized into two groups (satisfied or unsatisfied) based on overall satisfaction questionnaire. Pre- and post-operative objective clinical statuses were assessed with a knee scoring system based on the American Knee Society (AKS), the Western Ontario McMaster University Osteoarthritis Index (WOMAC), and range of motion.
Of the 88 patients, 85.2% were graded as satisfied according to the overall satisfaction estimation. The percentage of patients satisfied with pain relief, daily living functions, and cosmesis were 85.2%, 86.4%, and 86.4%, respectively. Multivariable logistic regression analysis demonstrated that pre-operative Hip-Knee-Ankle angle (HKAA) (odds ratio (OR) = 1.812), post-operative AKS knee score (OR = 1.156), and post-operative HKAA (OR = 0.717) were significantly associated with overall satisfaction. Pre-operative HKAA (OR = 1.436), post-operative WOMAC activity score (OR = 0.865), and post-operative HKAA (OR = 0.505) were significant predictors for satisfaction with pain reduction, daily living functions, and cosmesis, respectively.
Biplanar medial OWHTO is an effective treatment for osteoarthritis with varus deformity in terms of subjective satisfactory outcome. Several factors, including pre- and post-operative HKAA, post-operative AKS and WOMAC score, were significant predictors for subjective satisfaction.
Level of evidence: Level III
KeywordsOsteoarthritis Knee joint Opening-wedge high tibial osteotomy Patients reported outcomes Satisfaction Functional score
Compliance with ethical standards
Conflict of interest statement
The authors have no financial or personal relationship with other people or organizations that could inappropriately influence this study, including consultancies, employment, stock ownerships, paid expert testimony, honoraria, patient applications/registrations, and grants or other funding.
- 17.Duivenvoorden T, Brouwer RW, Baan A, Bos PK, Reijman M, Bierma-Zeinstra SM, Verhaar JA (2014) Comparison of closing-wedge and opening-wedge high tibial osteotomy for medial compartment osteoarthritis of the knee: a randomized controlled trial with a six-year follow-up. J Bone Joint Surg Am 96(17):1425–1432CrossRefPubMedGoogle Scholar
- 19.Berman AT, Bosacco SJ, Kirshner S, Avolio A Jr (1991) Factors influencing long-term results in high tibial osteotomy. Clin Orthop Relat Res 272:192–198Google Scholar
- 24.Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the knee society clinical rating system. Clin Orthop Relat Res 248:13–14Google Scholar
- 25.Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW (1998) Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 15(12):1833–1840Google Scholar
- 30.Miniaci A, Ballmer FT, Ballmer PM, Jakob RP (1989) Proximal tibial osteotomy. A new fixation device. Clin Orthop Relat Res 246:250–259Google Scholar
- 42.Yasuda K, Majima T, Tsuchida T, Kaneda K (1992) A ten- to 15-year follow-up observation of high tibial osteotomy in medial compartment osteoarthrosis. Clin Orthop Relat Res 282:186–195Google Scholar
- 43.Tsukada S, Wakui M (2015) Is overcorrection preferable for repair of degenerated articular cartilage after open-wedge high tibial osteotomy? Knee Surg Sports Traumatol Arthrosc 25(3):785–792. https://doi.org/10.1007/s00167-015-3655-z
- 44.Cass JR, Bryan RS (1998) High tibial osteotomy. Clin Orthop Relat Res 230:196–199Google Scholar