Abteilung Unfallchirurgie und Orthopädie, Krankenhaus Agatharied, Hausham, Germany.
Benedictus Krankenhaus Tutzing, Tutzing, Germany.
Arch Orthop Trauma Surg. 2022 Jul;142(7):1613-1622. doi: 10.1007/s00402-021-04100-x. Epub 2021 Aug 17.
High tibial osteotomy (HTO) is a valid and joint preserving surgical technique to treat medial degenerative osteoarthritis (OA) in young and active patients. A recent study shows that patients' expectations of osteotomy around the knee are high, but OA progression and potential conversion to a total knee arthroplasty (TKA) were underestimated. The aim of this study was to investigate surgeons' expectations of HTO and to compare the results to the patients' expectations and actual outcomes reported in the literature.
461 surgeons were questioned online using the 'Hospital for Special Surgery Knee Surgery Expectations Survey (HFSS-KSES)' and a ten-item non-validated questionnaire to investigate the expectations of HTO. Two subgroups were formed to investigate differences regarding the surgeons' experience. Statistical analysis was performed using IBM SPSS Statistics.
Surgeons' expectations of HTO were rated between very and little important with pain reduction being the most important item on the HFSS-KSES. Furthermore, 'improving the ability to walk', 'to perform daily activities', 'having confidence in the knee', and 'avoiding future degeneration' were rated of high importance. An important difference regarding the experience was the lower expectations on delay/prevention of TKA of less-experienced surgeons.
Surgeons' expectations of HTO are high but nevertheless different to the patients' expectations reported in the literature. Also, expectations for the delay/prevention of TKA differed regarding the experience of surgeons. While pain reduction represents one of the most important items for surgeons and patients, the expected outcome regarding the delay/prevention of a TKA and returning to sports differs to the patients' expectations and to the actual outcome reported in the literature. This should be considered when performing the preoperative informed consent.
高位胫骨截骨术（HTO）是一种有效的保关节手术技术，可用于治疗年轻且活跃的患者的内侧退行性骨关节炎（OA）。最近的一项研究表明，患者对膝关节周围截骨术的期望很高，但OA 进展和潜在的全膝关节置换术（TKA）转化率被低估了。本研究旨在调查外科医生对 HTO 的期望，并将其结果与文献中报道的患者期望和实际结果进行比较。
使用“特殊外科医院膝关节手术期望调查（HFSS-KSES）”和十项非验证性问卷对 461 名外科医生进行在线调查，以调查 HTO 的期望。形成了两个亚组，以调查外科医生经验方面的差异。使用 IBM SPSS Statistics 进行统计分析。
外科医生对 HTO 的期望评分介于非常重要和不太重要之间，其中减轻疼痛是 HFSS-KSES 上最重要的项目。此外，“提高行走能力”、“进行日常活动”、“对膝关节有信心”和“避免未来退化”被评为高度重要。经验方面的一个重要差异是经验较少的外科医生对 TKA 的延迟/预防的期望较低。
外科医生对 HTO 的期望很高，但与文献中报道的患者期望不同。此外，外科医生对 TKA 的延迟/预防的期望也因经验而异。虽然减轻疼痛是外科医生和患者最重要的项目之一，但对 TKA 延迟/预防和重返运动的预期结果与患者的期望和文献中报道的实际结果不同。在进行术前知情同意时应考虑到这一点。
