Patient-reported outcomes correlate with functional scores after opening-wedge high tibial osteotomy: a clinical study
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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.
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