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Patients’ expectations of osteotomies around the knee are high regarding activities of daily living

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

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.

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Funding

No funding.

Author information

Author notes

  1. Philipp Minzlaff and Tim Saier contributed equally.

Authors and Affiliations

  1. BG Traumahospital Tübingen, Trauma- and Reconstructive Surgery, University of Tübingen, Tübingen, Germany

    Leonard Grünwald & Steffen Schröter

  2. Department of Trauma Surgery, University Medical Center Regensburg and Sporthopaedicum Regensburg, Regensburg, Germany

    Peter Angele

  3. SozialStiftung Bamberg, Klinikum Bamberg, Bamberg, Germany

    Jörg Dickschas

  4. Regiomed Kliniken, Klinikum Lichtenfels, Lichtenfels, Germany

    Jörg Harrer

  5. OrthoPlus Munich, Munich, Germany

    Stefan Hinterwimmer

  6. Department of Orthopedics and Trauma Surgery, Medical Center, Albert-Ludwigs-University of Freiburg, Freiburg, Germany

    Matthias J. Feucht

  7. Department of Trauma and Reconstructive Surgery, ASKLEPIOS Clinic St. Georg, Hamburg, Germany

    Achim Preiss

  8. Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, Frankfurt, Germany

    Philipp Minzlaff

  9. Abteilung für Sportorthopädie, Chirurgisches Klinikum München Süd, Am Isarkanal 30, 81379, Muchen, Germany

    Philipp Minzlaff

  10. Berufsgenossenschaftliche Unfallklinik Murnau, Murnau, Germany

    Tim Saier

Authors
  1. Leonard Grünwald
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  2. Peter Angele
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Contributions

LG: creation of the database, data acquisition, statistics, and drafting the manuscript. PA: involved in study design, data acquisition, literature research, and final editing. SS: involved in study design, data acquisition, literature research, and final editing, JH: involved in study design, data acquisition, literature research, and final editing. JD: involved in study design, data acquisition, literature research, and final editing. SH: involved in study design, data acquisition, literature research, and final editing. AP: involved in study design, data acquisition, literature research, and final editing. PM: created the study design, data acquisition, literature research, and final editing. TS: created the study design, data acquisition, and final editing.

Corresponding author

Correspondence to Tim Saier.

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Ethical approval

All procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Conflict of interest

The authors declare that they have no conflict of interest.

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Cite this article

Grünwald, L., Angele, P., Schröter, S. et al. Patients’ expectations of osteotomies around the knee are high regarding activities of daily living. Knee Surg Sports Traumatol Arthrosc 27, 3022–3031 (2019). https://doi.org/10.1007/s00167-018-5326-3

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  • DOI: https://doi.org/10.1007/s00167-018-5326-3

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