Description
Abstract:
Background
Multiple studies have explored the progression of SIFK and probability of surgical intervention, but most are limited by a small sample size. This study aimed to investigate the probability of SIFK patients requring surgery, the types of surgeries performed, and the factors associated with the surgical intervention.
Methods
We analyzed 161 patients who attended our outpatient clinic between January 2019 and June 2022 with ICD-10 codes indicating necrosis. Various preoperative patient characteristics, including demographic and radiographic variables, were assessed. Patients were followed up for average 1101.3days, and relevant statistical methods were employed for the analysis.
Results
37.3% of the SIFK patients (60 individuals) required surgical intervention. Among these, 58 patients underwent total knee arthroplasty (TKA, 96.7%), and 2 patients underwent high tibial osteotomy (HTO, 3.3%). Significant differences between the two groups were demostrated by the following variables : Progression(p-value < 0.001), Target(P-value 0.042), Age(P-value 0.013), Height(P-value 0.029), HKA(P-value 0.001), MPTA(P-value 0.009), mLDFA(P-value 0.014) and Area(P-value 0.009). In the Cox regression analysis, significant predictors included Progression(HR 2.44, P-value 0.001), MPTA(HR 0.85, P-value 0.001) and mLDFA(HR 1.17, P-value 0.011).
Conclusion
Approximately 37.3% of SIFK patients underwent surgery, and the likelihood of surgery increased with the progression of X-ray and the presence of lower MPTA and higher mLDFA. SIFK patients exhibiting rapid x-ray progression and severe varus deformities should be closely monitored.
Keywords: SIFK, SONK, Necrosis
