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Severe medial osteoarthritis predicts patient dissatisfaction after proximal fibular osteotomy: a mid- to long-term follow-up study

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Abstract

Purpose

This study aimed to investigate postoperative patient satisfaction at mid- to long-term follow-up after proximal fibular osteotomy and to identify risk factors for patient dissatisfaction.

Methods

This was a retrospective cross-sectional study that included 252 knees from 160 osteoarthritis (OA) patients who underwent proximal fibular osteotomy with a follow-up of four to eight years. Patients were categorized into a satisfied group (satisfaction score ≥ 20) or a dissatisfied group (satisfaction score < 20) based on the New Knee Society Score (New KSS). Patient demographics, preoperative pain visual analogue scale (VAS) score, preoperative Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, Kellgren–Lawrence (K-L) grade, preoperative hip-knee-ankle (HKA) angle, and preoperative medial proximal tibial angle (MPTA) were compared between the two groups. Multiple logistic regression analysis was used to identify risk factors for patient dissatisfaction.

Results

Of the 203 knees, 130 (64.0%) were satisfied with their results. Multiple logistic regression analysis demonstrated that severe medial OA (K-L grade = IV) was an independent risk factor for patient dissatisfaction after proximal fibular osteotomy (OR 8.334, 95% CI 3.815–18.206, P < 0.001).

Conclusion

Our study confirmed that proximal fibular osteotomy was a simple and effective treatment for medial OA patients, and majority of our patients obtained a higher satisfaction rate within mid- to long-term follow-up after surgery. Severe medial OA, however, was an independent risk factor for dissatisfaction.

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Data availability

All the data and materials are available upon requests from the corresponding author.

Code availability

No code is required for this study.

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Funding

This study was supported by the Major Program of the National Natural Science Foundation of China (32130052, 91949203).

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Author notes

  1. Chunxu Fu and Fengkun Wang contributed equally to this work.

Authors and Affiliations

  1. School of Medicine, Nankai University, Tianjin, 300071, People’s Republic of China

    Chunxu Fu, Fengkun Wang & Yingze Zhang

  2. Hebei Medical University, Shijiazhuang, Hebei, 050051, People’s Republic of China

    Yanbin Zhu, Guimiao Li, Peizhi Yuwen & Yingze Zhang

  3. Key Laboratory of Biomechanics of Hebei Province, Hebei Orthopedic Research Institute, Shijiazhuang, Hebei, 050051, People’s Republic of China

    Yanbin Zhu, Guimiao Li, Peizhi Yuwen & Yingze Zhang

  4. Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, People’s Republic of China

    Dengying Wu, Zijian Yan & Yingze Zhang

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  1. Chunxu Fu
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Contributions

Chunxu Fu, Fengkun Wang, and Yingze Zhang: study design and performance. Yanbin Zhu, Guimiao Li, and Peizhi Yuwen: data collection and data analysis. Dengying Wu and Zijian Yan: data interpretation. Chunxu Fu and Fengkun Wang: drafting of the manuscript. Yingze Zhang: revising manuscript content. Yingze Zhang: supported the study and approved the final version of the manuscript. All authors approved the submitted version.

Corresponding author

Correspondence to Yingze Zhang.

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Ethics approval

All procedures performed in studies 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. This retrospective study was approved by the Ethical Committee of the Third Hospital of Hebei Medical University.

Consent to participate

Informed consent to participate was obtained from all individual participants included in the study prior to initiating data collection.

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The authors affirm that human research participants provided informed consent for the publication of the images in Fig. 1.

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The authors declare no competing interests.

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Fu, C., Wang, F., Zhu, Y. et al. Severe medial osteoarthritis predicts patient dissatisfaction after proximal fibular osteotomy: a mid- to long-term follow-up study. International Orthopaedics (SICOT) 48, 95–101 (2024). https://doi.org/10.1007/s00264-023-06036-w

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  • DOI: https://doi.org/10.1007/s00264-023-06036-w

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