This article is more than 5 years old. Information may no longer be current.
Correlation seen between ROM after ankle replacement and PROMs
Click Here to Manage Email Alerts
SEATTLE — Radiographic sagittal plane range of motion after total ankle replacement was positively associated with patient-reported outcomes, according to a presenter at the American Orthopaedic Foot and Ankle Society Annual Meeting.
“So basically, greater range of motion (ROM) equals better postoperative patient-reported outcome measures (PROMs),” Kamran Hamid, MD, MPH, said during his presentation.
He added, “When we looked at preoperative to postoperative changes in all of these outcome measures, they were significant as far as what is published for [minimal clinically important differences] MCIDs.”
Hamid and colleagues conducted a 2-year minimum follow-up of 88 patients who underwent total ankle replacement. Inclusion criteria included preoperative and postoperative measures for the foot and ankle disability index (FADI), short musculoskeletal function assessment (SMFA) bother and function indices, VAS and SF-36. Investigators collected standardized weight-bearing maximum dorsiflexion radiographs and plantarflexion sagittal radiographs.
Findings showed from the preoperative evaluation to the most recent follow-up visits, all PROMs improved. There was a significant correlation between final ankle ROM and postoperative FADI, SF-36 mental component score, SMFA bother and function indices and VAS score.
Hamid and colleagues also found FADI, SF-36 mental component score and SMFA function were positively correlated with dorsiflexion; however, these outcomes were not impacted by plantarflexion. There were no differences seen for prosthesis type, fixed-bearing design, mobile-bearing design and etiology. – by Monica Jaramillo
Reference:
Hamid K, et al. The value of motion: Patient-reported outcome measures are correlated with range of motion in total ankle replacement. Presented at: American Orthopaedic Foot and Ankle Society Annual Meeting; July 12-15, 2017; Seattle.
Disclosure: Hamid reports no relevant financial disclosures.
Perspective
Back to Top
Gregory C. Berlet, MD, FRCS(C), FAOA
The treatment paradigm for ankle arthritis is evolving toward motion-sparing options, like total ankle arthroplasty. This transition is being driven by consumer demand and the longer-term challenges with ankle arthrodesis. The published literature supports good patient outcomes with total ankle arthroplasty, but the dissection of what drives outcomes is still evolving. It is intuitive that better range of motion leads to better patient outcomes, but this is one of the first papers to correlate this and distinguishes this specific factor from pain relief. The key take-away from this research is that obtaining pain relief from ankle arthritis is perhaps not good enough and patient satisfaction, as measured by PROMs, point to functional recovery of ankle ROM as being a critical factor for patient perception of wellness.Click Here to Manage Email Alerts