Keppler L, Navarre F, Keppler A M, Ihle C, Becker J, Fürmetz J, Saier T
Department of Traumatology and Reconstructive Surgery, Berufsgenossenschaftliche Unfallklinik Murnau, Academic Hospital Technische Universität München (TUM), Murnau Am Staffelsee, Germany.
Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Munich, Germany.
Arch Orthop Trauma Surg. 2024 Dec 23;145(1):87. doi: 10.1007/s00402-024-05728-1.
The aim of this study was to investigate on fulfillment of expectations and patient satisfaction after surgical treatment of complex proximal tibial fractures.
In this prospective study 114 patients who suffered a complex tibial fracture (AO/OTA-Type B and C) were enrolled. At follow-up, based on the Hospital For Special Surgery-Knee Surgery Expectations Survey (HFSS-KSES), an individualized questionnaire was used to evaluate whether the preoperative formulated expectations had been fulfilled. In addition, condition of the knee joint (rated 0-4), overall satisfaction (rated 0-4) with the outcome, the Knee injury and Osteoarthritis Outcome Score (KOOS), and SF-12 was used.
Fulfillment of expectations for abilty to run, to knee, and regain an intact status of the knee joint performed worst in the HFSS-KSE. Highest fulfillment was reached for psychological well-being and to interact socially. No statistical difference was found between the two fracture groups (AO/OTA-Type B vs. C). In the study cohort n = 81 patients (83.5%) were satisfied or very satisfied with the outcome. Mean satisfaction in the study cohort was 3.5. Satisfaction correlated highly significant with all items of the HFSS-KSE survey. Results vary in the different fracture groups. Satisfaction also correlates highly significant with the condition of the knee joint as well as with all dimensions of the KOOS score and the PCS of the SF-12 survey.
In patients who suffered a complex proximal tibial fracture, fulfillment of preoperative expectations is only limited. Nevertheless, overall satisfaction with the outcome is high, and correlates to a high degree with fulfillment of joint functionality and current health status. The fracture type does not influence these results.
本研究旨在调查复杂胫骨近端骨折手术治疗后的期望达成情况及患者满意度。
在这项前瞻性研究中，纳入了114例患有复杂胫骨骨折（AO/OTA B型和C型）的患者。随访时，基于特种外科医院膝关节手术期望调查（HFSS-KSES），使用一份个性化问卷来评估术前设定的期望是否达成。此外，还使用了膝关节状况（0至4级评分）、对结果的总体满意度（0至4级评分）、膝关节损伤和骨关节炎疗效评分（KOOS）以及SF-12。
在HFSS-KSE中，对跑步能力、下跪能力以及恢复膝关节完整状态的期望达成情况最差。心理健康和社交互动方面的期望达成率最高。两组骨折患者（AO/OTA B型与C型）之间未发现统计学差异。在研究队列中，n = 81例患者（83.5%）对结果感到满意或非常满意。研究队列中的平均满意度为3.5。满意度与HFSS-KSE调查的所有项目高度相关。不同骨折组的结果有所不同。满意度还与膝关节状况以及KOOS评分的所有维度和SF-12调查的PCS高度相关。
对于复杂胫骨近端骨折患者，术前期望的达成程度有限。然而总体对结果的满意度较高，且与关节功能的达成情况和当前健康状况高度相关。骨折类型不影响这些结果。
