Correlation of the AOFAS scores with a generic health qualy score in foot and ankle surgery

Background: The American Orthopaedic Foot and Ankle Score (AOFAS) is one scoring system used to assess and monitor the progress of patients after foot and ankle surgery. The aim of this study was to evaluate the trend of the AOFAS score over a period of time and correlate it with the QUALY score, which is a valid and reliable scoring system. Methods: All patients undergoing surgery by one foot and ankle surgeon between January, 2001, and July, 2003, were reviewed. The preoperative AOFAS and QUALY and postoperative scores at 3, 6 and 12 months, and yearly were collected prospectively. Results: This study includes 204 operative procedures in 159 patients. The mean age of the patients was 51.9 (range 12 to 89) years. The AOFAS scores increased from a mean of 45.5 preoperatively to 76.5 at 3 months and reached a peak of 81.5 at 6 months and then started to decrease to 79.2 at 12 months. This fall, though seemingly marginal, was significant (p < 0.01). This trend seems to be consistent for all the procedures. The 6-month AOFAS score was found to have a higher correlation with the final QUALY score (r(2) = 0.423) than the 12-month AOFAS score (r(2) = 0.326). Conclusions: The AOFAS score has low levels of correlation with the validated generic health QUALY score. Our study suggests that scores collected preoperatively, at 6 and 12 months after surgery, and annually there after may be best. The 3-month score may not be necessary. We recommend that a generic health score such as the QUALY score be used in conjunction with the AOFAS score to reflect outcome.