• J Arthroplasty · Dec 2020

    Patient Expectations and Satisfaction After Medial Opening Wedge High Tibial Osteotomy.

    • Man Soo Kim, In Jun Koh, Chul Kyu Kim, Keun Young Choi, Jun Seo Yang, and Yong In.
    • Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
    • J Arthroplasty. 2020 Dec 1; 35 (12): 3467-3473.

    BackgroundThe objective of this study is to assess preoperative patient expectations of medial opening wedge high tibial osteotomy (MOWHTO) and related postoperative fulfillment, to increase understanding of associated factors of postoperative satisfaction.MethodsOne hundred fifteen patients who underwent MOWHTO were enrolled. Patients' expectations were measured using the Hospital for Special Surgery-Knee Replacement Expectations Survey. Fulfillment of expectations and satisfaction was evaluated using the Hospital for Special Surgery Knee Replacement Fulfillment of Expectations Survey and a 5-point Likert scale at 2 years, postoperatively. The discrepancies between preoperative expectation and postoperative fulfillment score were also assessed. Preoperative and postoperative patient-reported outcomes were evaluated using Western Ontario and McMaster Universities Arthritis Index (WOMAC) score. Univariate and multivariate analyses were performed to model predictions for satisfaction.ResultsThe most expected items were "pain relief," "walking ability," and "perform daily activities." The top 3 items with the biggest discrepancies between expectation and fulfillment scores were "kneeling," "squatting," and "pain relief." Ninety patients (78.3%) were satisfied and 25 (21.7%) were dissatisfied at 2 years postoperative. Multivariate logistic regressions showed that patient expectations did not affect satisfaction. Small discrepancies between expectation and fulfillment scores (odds ratio [OR] 105.304, 95% confidence interval 20.974-528.714, P < .001), high postoperative fulfillment scores (OR 1.198, 95% CI 1.110-1.293, P < .001), and low postoperative Western Ontario and McMaster Universities Arthritis Index total scores (OR 0.932, 95% CI 0.894-0.971, P < .001) were significantly associated with patient satisfaction.ConclusionThe small discrepancy between preoperative expectations and postoperative fulfillment of expectations was a major contributor to patients' satisfaction following MOWHTO.Copyright © 2020 Elsevier Inc. All rights reserved.

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