Leonard Grünwald1, Peter Angele2, Steffen Schröter1, Jörg Dickschas3, Jörg Harrer4, Stefan Hinterwimmer5, Matthias J Feucht6, Achim Preiss7, Philipp Minzlaff8,9, Tim Saier10. 1. BG Traumahospital Tübingen, Trauma- and Reconstructive Surgery, University of Tübingen, Tübingen, Germany. 2. Department of Trauma Surgery, University Medical Center Regensburg and Sporthopaedicum Regensburg, Regensburg, Germany. 3. SozialStiftung Bamberg, Klinikum Bamberg, Bamberg, Germany. 4. Regiomed Kliniken, Klinikum Lichtenfels, Lichtenfels, Germany. 5. OrthoPlus Munich, Munich, Germany. 6. Department of Orthopedics and Trauma Surgery, Medical Center, Albert-Ludwigs-University of Freiburg, Freiburg, Germany. 7. Department of Trauma and Reconstructive Surgery, ASKLEPIOS Clinic St. Georg, Hamburg, Germany. 8. Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, Frankfurt, Germany. 9. Abteilung für Sportorthopädie, Chirurgisches Klinikum München Süd, Am Isarkanal 30, 81379, Muchen, Germany. 10. Berufsgenossenschaftliche Unfallklinik Murnau, Murnau, Germany. tim.saier@bgu-murnau.de.
Abstract
PURPOSE: This study was conducted to investigate patients' expectations on high tibial osteotomies, distal femur osteotomies, and double-level osteotomies in different health-related domains. It was hypothesized that expectations are high in terms of capacity to work, pain relief, and restoring knee function. METHODS: A total of 264 patients (age 47 years ± 11 years) were enrolled in this study from March 2015 until May 2016 in seven specialized orthopaedic surgery departments. Data were collected via the Knee injury and Osteoarthritis Outcome Score, the Hospital for Special Surgery-Knee Surgery Expectations Survey, and a ten-item (non-validated) questionnaire to specifically ask about expectations of osteotomies around the knee 24-48 h prior to surgery. In addition, self-efficacy was assessed. Parametric tests were used to test the hypothesis. RESULTS: Knee injury and Osteoarthritis Outcome Score test results showed that all patients suffered because of their knee impairments prior to surgery. All participants had high expectations in all aspects regarding the surgical outcome: on a four-point Likert scale ranging from 1 (very important) to 4 (not important), all mean values were between 1.2 and 1.7. For patients who had a demanding physical work, the ability to keep a stressful working posture was more important than for other patients (i.e. to kneel, to squat). Furthermore, preoperative lower quality of life was associated with higher expectations concerning improving the ability to walk, to achieve improvements in activities of daily living and social well-being. CONCLUSIONS: Patients' expectations of osteotomies around the knee are high in terms of capacity to work, pain relief, and restoring functions. The natural course of osteoarthritis and the potential need for conversion to TKA were underestimated by a substantial proportion of the study population. However, the expectation regarding survival rate is in line with the reported literature. The results of this study should assist surgeons in discussing realistic expectations when considering and counselling patients regarding osteotomies around the knee. This may help to clarify realistic expectations preoperatively and ultimately improve patients' satisfaction. LEVEL OF EVIDENCE: Therapeutic study, Level II.
PURPOSE: This study was conducted to investigate patients' expectations on high tibial osteotomies, distal femur osteotomies, and double-level osteotomies in different health-related domains. It was hypothesized that expectations are high in terms of capacity to work, pain relief, and restoring knee function. METHODS: A total of 264 patients (age 47 years ± 11 years) were enrolled in this study from March 2015 until May 2016 in seven specialized orthopaedic surgery departments. Data were collected via the Knee injury and Osteoarthritis Outcome Score, the Hospital for Special Surgery-Knee Surgery Expectations Survey, and a ten-item (non-validated) questionnaire to specifically ask about expectations of osteotomies around the knee 24-48 h prior to surgery. In addition, self-efficacy was assessed. Parametric tests were used to test the hypothesis. RESULTS:Knee injury and Osteoarthritis Outcome Score test results showed that all patients suffered because of their knee impairments prior to surgery. All participants had high expectations in all aspects regarding the surgical outcome: on a four-point Likert scale ranging from 1 (very important) to 4 (not important), all mean values were between 1.2 and 1.7. For patients who had a demanding physical work, the ability to keep a stressful working posture was more important than for other patients (i.e. to kneel, to squat). Furthermore, preoperative lower quality of life was associated with higher expectations concerning improving the ability to walk, to achieve improvements in activities of daily living and social well-being. CONCLUSIONS:Patients' expectations of osteotomies around the knee are high in terms of capacity to work, pain relief, and restoring functions. The natural course of osteoarthritis and the potential need for conversion to TKA were underestimated by a substantial proportion of the study population. However, the expectation regarding survival rate is in line with the reported literature. The results of this study should assist surgeons in discussing realistic expectations when considering and counselling patients regarding osteotomies around the knee. This may help to clarify realistic expectations preoperatively and ultimately improve patients' satisfaction. LEVEL OF EVIDENCE: Therapeutic study, Level II.
Authors: Thekla Esser; Tim Saier; Christina Valle; Marcus Schmitt-Sody; Matthias J Feucht; Peter M Prodinger; Philipp Minzlaff Journal: Arch Orthop Trauma Surg Date: 2021-08-17 Impact factor: 3.067
Authors: Alexander Hoorntje; P Paul F M Kuijer; Berbke T van Ginneken; Koen L M Koenraadt; Rutger C I van Geenen; Gino M M J Kerkhoffs; Ronald J van Heerwaarden Journal: Orthop J Sports Med Date: 2019-12-27