Pattern of recovery and outcomes of patient reported physical function and pain interference after ankle fusion: a retrospective cohort study

被引:3
作者
Kohring, Jessica M. [1 ]
Houck, Jeffrey R. [2 ]
Oh, Irvin [1 ]
Flemister, Adolf S. [1 ]
Ketz, John P. [1 ]
Baumhauer, Judith F. [1 ]
机构
[1] Univ Rochester, Dept Orthopaed, 601 Elmwood Ave,Box 665, Rochester, NY 14642 USA
[2] George Fox Univ, Dept Phys Therapy, Newberg, OR USA
关键词
Ankle fusion; Patient reported outcomes; Function; Pain; PROMIS; FUNCTION ITEM BANK; ARTHRODESIS; FIXATION; SCORES; FOOT;
D O I
10.1186/s41687-020-00203-y
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Background Research on outcomes after ankle fusion focuses on basic activities of daily living, fusion rates, and gait parameters. Little has been reported on the patient's perspective after surgery. The purpose of this study was to determine the change in patient reported physical function and pain interference after ankle fusion surgery to guide patient expectations and improve provider communication. Methods This was a retrospective review of prospectively collected patient reported outcome measurement information system (PROMIS) data in 88 ankle arthrodesis procedures performed from May 2015 to March 2018. The PROMIS Physical function (PF) and pain interference (PI) measures were collected as routine care. Linear mixed models were used to assess differences at each follow-up point for PF and PI. Preoperative to last follow-up in the 120-365 day interval was assessed using analysis of variance. Outcomes included T-scores, z-scores, and PROMIS-Preference (PROPr) utility scores for PF and PI and the percentage of patients improving by at least 4 T-score points. Results The linear mixed model analysis for PF after the 120-149 days, and for PI, after 90-119 days, indicated recovery plateaued at 39-40 for PF and 57-59 for PI T-scores. The change in the PI T-score was the greatest with a mean T-score improvement of - 5.4 (95% CI - 7.7 to - 3.1). The proportion of patients improving more than 4 points was 66.2% for either PF or PI or both. The change in utility T-scores for both PF (0.06, 95% CI 0.02 to 0.11) and PI (0.15, 95% CI 0.09 to 0.20) was significantly improved, however, only PI approached clinical significance. Conclusion Average patients undergoing ankle fusion experience clinically meaningful improvement in pain more so than physical function. Average patient recovery showed progressive improvement in pain and function until the four-month postoperative time point. Traditional dogma states that recovery after an ankle fusion maximizes at a year, however based on the findings in this study, 4 months is a more accurate marker of recovery. A decline in function or an increase in pain after 4 months from surgery may help to predict nonunion and other complications after ankle arthrodesis.
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共 29 条
  • [1] Development of a PROMIS item bank to measure pain interference
    Amtmann, Dagmar
    Cook, Karon F.
    Jensen, Mark P.
    Chen, Wen-Hung
    Choi, Seung
    Revicki, Dennis
    Cella, David
    Rothrock, Nan
    Keefe, Francis
    Callahan, Leigh
    Lai, Jin-Shei
    [J]. PAIN, 2010, 150 (01) : 173 - 182
  • [2] Determining Success or Failure After Foot and Ankle Surgery Using Patient Acceptable Symptom State (PASS) and Patient Reported Outcome Information System (PROMIS)
    Anderson, Michael R.
    Baumhauer, Judith F.
    DiGiovanni, Benedict F.
    Flemister, Sam
    Ketz, John P.
    Oh, Irvin
    Houck, Jeffrey R.
    [J]. FOOT & ANKLE INTERNATIONAL, 2018, 39 (08) : 894 - 902
  • [3] Abnormalities of gait caused by ankle arthritis are improved by ankle arthrodesis
    Brodsky, J. W.
    Kane, J. M.
    Coleman, S.
    Bariteau, J.
    Tenenbaum, S.
    [J]. BONE & JOINT JOURNAL, 2016, 98B (10) : 1369 - 1375
  • [4] Estimation of a Preference-Based Summary Score for the Patient-Reported Outcomes Measurement Information System: The PROMIS®-Preference (PROPr) Scoring System
    Dewitt, Barry
    Feeny, David
    Fischhoff, Baruch
    Cella, David
    Hays, Ron D.
    Hess, Rachel
    Pilkonis, Paul A.
    Revicki, Dennis A.
    Roberts, Mark S.
    Tsevat, Joel
    Yu, Lan
    Hanmer, Janel
    [J]. MEDICAL DECISION MAKING, 2018, 38 (06) : 683 - 698
  • [5] Medium- to Long-Term Outcome of Ankle Arthrodesis
    Hendrickx, Roel P. M.
    Stufkens, Sjoerd A. S.
    de Bruijn, Evelien E.
    Sierevelt, Inger N.
    van Dijk, C. Niek
    Kerkhoffs, Gino M. M. J.
    [J]. FOOT & ANKLE INTERNATIONAL, 2011, 32 (10) : 940 - 947
  • [6] Preoperative PROMIS Scores Predict Postoperative Success in Foot and Ankle Patients
    Ho, Bryant
    Houck, Jeff R.
    Flemister, Adolph S.
    Ketz, John
    Oh, Irvin
    DiGiovanni, Benedict F.
    Baumhauer, Judith F.
    [J]. FOOT & ANKLE INTERNATIONAL, 2016, 37 (09) : 911 - 918
  • [7] Improving Interpretation of the Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function Scale for Specific Tasks in Community-Dwelling Older Adults
    Houck, Jeff
    Jacobson, Ryan
    Bass, Michael
    Dasilva, Chris
    Baumhauer, Judith F.
    [J]. JOURNAL OF GERIATRIC PHYSICAL THERAPY, 2020, 43 (03) : 142 - 152
  • [8] Ability of Patient-Reported Outcomes to Characterize Patient Acceptable Symptom State (PASS) After Attending a Primary Care Physical Therapist and Medical Doctor Collaborative Service: A Cross-Sectional Study
    Houck, Jeff
    Kang, Daniel
    Cuddeford, Tyler
    Rahkola, Sarah
    [J]. ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION, 2019, 100 (01): : 60 - 66
  • [9] Radiographic and Functional Outcomes Following Bilateral Ankle Fusions
    Houdek, Matthew T.
    Wilke, Benjamin K.
    Ryssman, Daniel B.
    Turner, Norman S.
    [J]. FOOT & ANKLE INTERNATIONAL, 2014, 35 (12) : 1250 - 1254
  • [10] Responsiveness of the PROMIS and FAAM Instruments in Foot and Ankle Orthopedic Population
    Hung, Man
    Baumhauer, Judith F.
    Licari, Frank W.
    Bounsanga, Jerry
    Voss, Maren W.
    Saltzman, Charles L.
    [J]. FOOT & ANKLE INTERNATIONAL, 2019, 40 (01) : 56 - 64