TY - JOUR
T1 - Evaluating Prospective Patient-Reported Pain and Function Outcomes After Ankle and Hindfoot Arthrodesis
AU - Mehta, Manish P.
AU - Mehta, Mitesh P.
AU - Sherman, Alain E.
AU - Mutawakkil, Muhammad Y.
AU - Bell, Raheem
AU - Patel, Milap S.
AU - Kadakia, Anish R.
N1 - Publisher Copyright:
© The Author(s) 2021.
PY - 2021
Y1 - 2021
N2 - Background: Hindfoot and ankle fusions are mechanically limiting procedures for patients. However, patient-reported outcomes of these procedures have not been well studied. This study assessed outcomes of hindfoot and ankle fusions by using Patient-Reported Outcome Measurement Information System (PROMIS) Physical Function (PF) and Pain Interference (PI) Computer Adaptive Tests (CATs). Methods: Between 2014 and 2018, 102 patients were prospectively enrolled after presenting to a tertiary care facility for ankle and hindfoot fusions, including tibiotalar, tibiotalocalcaneal, subtalar, and triple arthrodeses. Study participants completed preoperative and 12-month postoperative PF and PI CATs. The differences between mean 12-month postoperative and preoperative PROMIS PF and PI T scores were analyzed with paired t tests. The relationship between the 12-month PF and PI differences for the overall sample and patient factors was examined using multiple regression modeling. Results: The sample had mean age of 57.69 years; 48% were male, and 55% were obese. Patients who underwent ankle and hindfoot arthrodesis had statistically significant improvements from preoperative to 12 months postoperative in mean PF (36.26±7.85 vs 39.38±6.46, P =.03) and PI (61.07±7.75 vs 56.62±9.81, P =.02). Triple arthrodesis saw the greatest increases in physical function (▵PF = 7.22±7.31, P =.01) and reductions in pain (▵PI = –9.17±8.31, P =.01), achieving minimal clinically important difference (MCID). Patients who underwent tibiotalar fusion had significant improvement in physical function (▵PF = 4.18±5.68, P =.04) and pain reduction that approached statistical significance (▵PI = –6.24±8.50, P =.09), achieving MCID. Older age (≥60 years ) was associated with greater improvements in PF (β = 0.20, P =.07) and PI (β = –0.29, P =.04). Preoperative PF and PI T scores were significantly associated with the 12-month change in PF and PI T scores, respectively (β = –0.74, P <.01; β = –0.61, P <.01). Conclusion: Hindfoot and ankle fusions are procedures with favorable patient outcomes leading to increased physical function and decreased pain at 12 months postoperation relative to preoperation. Level of Evidence: Level II, prospective comparative study.
AB - Background: Hindfoot and ankle fusions are mechanically limiting procedures for patients. However, patient-reported outcomes of these procedures have not been well studied. This study assessed outcomes of hindfoot and ankle fusions by using Patient-Reported Outcome Measurement Information System (PROMIS) Physical Function (PF) and Pain Interference (PI) Computer Adaptive Tests (CATs). Methods: Between 2014 and 2018, 102 patients were prospectively enrolled after presenting to a tertiary care facility for ankle and hindfoot fusions, including tibiotalar, tibiotalocalcaneal, subtalar, and triple arthrodeses. Study participants completed preoperative and 12-month postoperative PF and PI CATs. The differences between mean 12-month postoperative and preoperative PROMIS PF and PI T scores were analyzed with paired t tests. The relationship between the 12-month PF and PI differences for the overall sample and patient factors was examined using multiple regression modeling. Results: The sample had mean age of 57.69 years; 48% were male, and 55% were obese. Patients who underwent ankle and hindfoot arthrodesis had statistically significant improvements from preoperative to 12 months postoperative in mean PF (36.26±7.85 vs 39.38±6.46, P =.03) and PI (61.07±7.75 vs 56.62±9.81, P =.02). Triple arthrodesis saw the greatest increases in physical function (▵PF = 7.22±7.31, P =.01) and reductions in pain (▵PI = –9.17±8.31, P =.01), achieving minimal clinically important difference (MCID). Patients who underwent tibiotalar fusion had significant improvement in physical function (▵PF = 4.18±5.68, P =.04) and pain reduction that approached statistical significance (▵PI = –6.24±8.50, P =.09), achieving MCID. Older age (≥60 years ) was associated with greater improvements in PF (β = 0.20, P =.07) and PI (β = –0.29, P =.04). Preoperative PF and PI T scores were significantly associated with the 12-month change in PF and PI T scores, respectively (β = –0.74, P <.01; β = –0.61, P <.01). Conclusion: Hindfoot and ankle fusions are procedures with favorable patient outcomes leading to increased physical function and decreased pain at 12 months postoperation relative to preoperation. Level of Evidence: Level II, prospective comparative study.
KW - PROMIS
KW - ankle fusion
KW - hindfoot fusion
KW - patient-reported outcomes
UR - http://www.scopus.com/inward/record.url?scp=85118267448&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85118267448&partnerID=8YFLogxK
U2 - 10.1177/24730114211040740
DO - 10.1177/24730114211040740
M3 - Article
C2 - 35097472
AN - SCOPUS:85118267448
SN - 2473-0114
VL - 6
JO - Foot and Ankle Orthopaedics
JF - Foot and Ankle Orthopaedics
IS - 4
ER -