Clinical Outcomes Evaluation of Combined Valgus and Chiari Osteotomy Inconsistent with Patient Satisfaction

The Japanese Orthopaedic Association Hip-Disease Evaluation Questionnaire, which is tailored to Japanese lifestyles, has recently been developed in Japan as a patient-reported outcome measure. In this study, combined valgus and Chiari osteotomy were evaluated using the JHEQ and JOA scores. The subjects were 42 hips of 39 patients with a mean age at surgery of 45.3 years. The mean follow-up period was 95.3 months. Radiological osteoarthritis stage, preoperative and postoperative JOA scores, JHEQ score at final follow-up, and patient dissatisfaction with hip joint status rated on a visual analog scale were evaluated. The factors that affected patient dissatisfaction were also identified using multiple regression analysis. Radiological osteoarthritis stage at final follow-up was either maintained or improved in 85.7%. The mean JOA score improved from 57.2 preoperatively to 78.7 at final follow-up. The JHEQ score at final follow-up, however, was low, at 43.3 points. Patients who were comparatively satisfied accounted for 47.6%. Of the JHEQ subscales, movement had the lowest scores, and this was the subscale that had the greatest effect on patient dissatisfaction. The present results suggest that the results of JOA score are inconsistent for postoperative patients' satisfaction after CVCO, and patient-based evaluation tool must also be used.

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