Predictive factors for satisfaction after contemporary unicompartmental knee arthroplasty and high tibial osteotomy in isolated medial femorotibial osteoarthritis

Koh, In Jun; Kim, Man Soo; Sohn, Sueen; Song, Kwang Yun; Choi, Nam Yong; Jung, Ho-Young; In, Yong

doi:10.1016/j.otsr.2018.11.001

Cited by 50 publications

(42 citation statements)

References 35 publications

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“…2,13,19 Han et al 18 reported that overcorrection was associated with cosmetic dissatisfaction and was furthermore a negative predictor of overall postoperative satisfaction. In contrast, Koh et al 23 reported that there was no association between dissatisfaction after OWHTO and postoperative alignment. In this study, we did not detect an association between the satisfied and dissatisfied groups with respect to the mean postoperative WBLR.…”

Section: Discussionmentioning

confidence: 92%

“…12,15,16,20 Only a few studies have reported on factors associated with patient satisfaction after OWHTO. Koh et al 23 showed that severe OA was associated with dissatisfaction after OWHTO. Han et al 18 reported that pre-and postoperative limb alignment as well as postoperative clinical scores were significant predictors of subjective satisfaction.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have shown an association between severe articular destruction and unfavorable clinical outcomes after HTO. 1,9,11,35 Moreover, Koh et al 23 reported that preoperative severe OA (Ahlbä ck grade !2) was a significant predictor of patient dissatisfaction after OWHTO. In contrast, in a large series of 533 cases in which a rigid long plate was used, Floerkemeier et al 12 reported that the preoperative OA grade did not affect the Oxford Knee Score.…”

Section: Discussionmentioning

confidence: 99%

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Factors Associated With Patient Satisfaction After Opening-Wedge High Tibial Osteotomy

Goshima

Sawaguchi

Shigemoto

et al. 2020

Orthopaedic Journal of Sports Medicine

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Background: Opening-wedge high tibial osteotomy (OWHTO) is expected to result in higher patient satisfaction compared with knee arthroplasty due to joint preservation. However, patient satisfaction rates as well as factors associated with satisfaction after OWHTO remain unclear. Purpose: To evaluate patient subjective satisfaction after OWHTO and determine factors associated with patient satisfaction after OWHTO. Study Design: Case-control study; Level of evidence, 3. Methods: This study enrolled 123 patients (123 knees) who underwent unilateral OWHTO. Clinical parameters, including range of motion (ROM), visual analog scale (VAS) score for pain, Knee injury and Osteoarthritis Outcome Score (KOOS), weightbearing line ratio (WBLR), and medial proximal tibial angle (MPTA), were assessed before surgery and at the final follow-up at a minimum of 2 years. Patient satisfaction was evaluated using a 5-point scale regarding (1) surgery, (2) pain relief, (3) knee mobility, (4) daily living function, and (5) lower extremity alignment. The mean overall satisfaction scores for the 5 questions were calculated, and the sample was divided into 2 main groups (satisfied or unsatisfied). Preoperative characteristics, physical activity level, patient expectations for surgery, ROM, and KOOS were compared between the groups. Cartilage regeneration was assessed at the time of plate removal, and WBLR and MPTA were also assessed. Factors associated with patient satisfaction were analyzed using multivariable logistic regression analysis. Results: The mean ± SD follow-up was 54.6 ± 20.6 months. The mean WBLR significantly changed from 20.7% ± 11.8% preoperatively to 66.9% ± 10.2% at the final follow-up, and all KOOS subscale scores significantly improved after surgery. Of the 123 patients, 109 (88.6%) were graded as satisfied. Factors associated with patient satisfaction were expectations met (odds ratio, 17.4; P = .026), better postoperative KOOS Pain score (odds ratio, 1.30; P = .001), and better postoperative KOOS Activities of Daily Living score (odds ratio, 1.36; P = .002). Conclusion: OWHTO is an effective treatment in terms of subjective satisfactory outcomes. Patient expectations for surgery have a significant effect on patient satisfaction. Surgeons should consider patient expectations before OWHTO and provide patient education to improve patient satisfaction.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Factors Associated With Patient Satisfaction After Opening-Wedge High Tibial Osteotomy

Goshima

Sawaguchi

Shigemoto

et al. 2020

Orthopaedic Journal of Sports Medicine

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“…We tried to use the patient expectations and satisfaction score of KSS as the clinical outcomes, however the results showed there were no model built with statistical significance based on our existing independent variables (data not shown). We considered there might be more factors affected subjective outcomes, such as preoperative pain and disability, education level, telerehabilitation, age, and so forth [ 60 – 62 ]. Thus, a further prediction model including these factors as independent variables to predict patient expectations and satisfaction score can be more integrated and comprehensive.…”

Section: Discussionmentioning

confidence: 99%

How to predict early clinical outcomes and evaluate the quality of primary total knee arthroplasty: a new scoring system based on lower-extremity angles of alignment

Chen

Deng

et al. 2020

BMC Musculoskelet Disord

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Background A method that can accurately predict the outcome of surgery can give patients timely feedback. In addition, to some extent, an objective evaluation method can help the surgeon quickly summarize the patient’s surgical experience and lessen dependence on the long wait for follow-up results. However, there was still no precise tool to predict clinical outcomes of total knee arthroplasty (TKA). This study aimed to develop a scoring system to predict clinical results of TKA and then grade the quality of TKA. Methods We retrospectively reviewed 98 primary TKAs performed between April 2013 and March 2017 to determine predictors of clinical outcomes among lower-extremity angles of alignment. Applying multivariable linear-regression analysis, we built Models (i) and (ii) to predict detailed clinical outcomes which were evaluated using the Knee Society Score (KSS). Multivariable logistic-regression analysis was used to establish Model (iii) to predict probability of getting a good clinical outcome (PGGCO) which was evaluated by Knee Injury and Osteoarthritis Outcome Score (KOOS) score. Finally, we designed a new scoring system consisting of 3 prediction models and presented a method of grading TKA quality. Thirty primary TKAs between April and December 2017 were enrolled for external validation. Results We set up a scoring system consisting of 3 models. The interpretations of Model (i) and (ii) were good (R 2 = 0.756 and 0.764, respectively). Model (iii) displayed good discrimination, with an area under the curve (AUC) of 0.936, and good calibration according to the calibration curve. Quality of surgery was stratified as follows: “A” = PGGCO ≥0.8, “B” = PGGCO ≤0.6 but < 0.8, and “C” = PGGCO < 0.6. The scoring system performed well in external validation. Conclusions This study first developed a validated, evidence-based scoring system based on lower-extremity angles of alignment to predict early clinical outcomes and to objectively evaluate the quality of TKA.

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“…Changes in demographics and physical activities of the younger population have increased the number of patients with medial unicompartmental knee osteoarthritis requiring surgical intervention. [ 1 – 3 ] Conservative surgical procedures such as core decompression, arthroscopic debridement, or high tibial osteotomy are effective in the early stage of the disease, but when bone-on-bone osteoarthritis occurs, a knee arthroplasty is often required. [ 4 – 6 ]…”

Section: Introductionmentioning

confidence: 99%

Unicondylar knee arthroplasty versus total knee arthroplasty in adults with isolated medial osteoarthritis

Yin¹,

Qian²,

Wu³

et al. 2020

Medicine

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Background: The choice between unicondylar knee arthroplasty (UKA) and total knee arthroplasty (TKA) is likely to have long-term implications for patient-reported health outcomes. However, high-quality studies that compare the outcomes of TKA and UKA and their effects are still lacking in the literature. Thus, the aim of the present study was to compare the UKA and TKA techniques with regard to functional outcomes and perioperative complications in patients who had isolated medial osteoarthritis. Methods: This was a retrospective, single-center, matched-controlled study performed with approval of our hospital (Kunshan hospital of Traditional Chinese Medicine affiliated to Nanjing University of Traditional Chinese Medicine), with the ethics number KZY2020–37. To reduce the effect of selection bias and potential confounding in this observational study, a 1:1 matching algorithm was applied. The groups were split by sex, age to within 6 years, and body mass index within 5 kg/m 2 . Thus, we retrospectively reviewed the records of 240 consecutively enrolled patients who underwent UKA and 240 patients who underwent TKA from January 2013 to June 2015 from the database of our institution. Written informed consent was obtained from all subjects participating in the trial. Clinical outcomes included range of motion, Short Form 12 score, new Knee Society Score, Western Ontario and McMaster Universities Arthritis Index, and the complications. The outcome measures were evaluated by a physiotherapist and were assessed preoperatively and postoperatively at 6 months and 2 years. The mean follow-up time was 3 years. Conclusion: We hypothesized that there was no significant difference between the 2 groups in terms of postoperative outcomes. Trial registration: Our study was registered in Research Registry (researchregistry5828).

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Predictive factors for satisfaction after contemporary unicompartmental knee arthroplasty and high tibial osteotomy in isolated medial femorotibial osteoarthritis

Cited by 50 publications

References 35 publications

Factors Associated With Patient Satisfaction After Opening-Wedge High Tibial Osteotomy

Factors Associated With Patient Satisfaction After Opening-Wedge High Tibial Osteotomy

How to predict early clinical outcomes and evaluate the quality of primary total knee arthroplasty: a new scoring system based on lower-extremity angles of alignment

Unicondylar knee arthroplasty versus total knee arthroplasty in adults with isolated medial osteoarthritis

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