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Söderpalm AC, Montgomery F, Helander KN, Cöster MC. Hallux valgus; An observational study on patient characteristics, surgical treatment and pre-operative HRQoL from the Swedish foot and ankle register (Swefoot). Foot (Edinb) 2023; 57:102060. [PMID: 37922633 DOI: 10.1016/j.foot.2023.102060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 10/21/2023] [Accepted: 10/29/2023] [Indexed: 11/07/2023]
Abstract
INTRODUCTION Hallux valgus (HV) is a common condition with impact on pain, function and HrQoL. International consensus does not exist on operative treatment of HV and population-level data regarding surgical treatment of HV is lacking. In this study we aimed to present base-line data from surgically treated HV patients reported to the Swedish register for foot and ankle surgery (Swefoot) during the period 2014-2021. MATERIAL AND METHODS In total, 7543 feet in 6770 patients were analyzed regarding patient characteristics, grading of HV, surgical procedures and pre-operative PROMs Euroqol-5 Dimension-3 L (EQ-5D-3 L) and Self-reported Foot and Ankle Score (SEFAS). RESULTS Median age was 55 years (range 15-91) and 87% were women. The surgeon classified 63% of the cases as moderate HV, 15% as mild and 22% as severe. The Chevron osteotomy was the preferred surgical method and was used in 74% of all cases. Out of these, 58% were fixated with a screw. The Offset-V osteotomy was the most performed shaft osteotomy. Proximal osteotomies and lateral releases were less common. The pre-operative mean EQ-5D-3 L index and SEFAS summary score were low and HV patients with overweight and rheumatoid arthritis had significantly lower scores. CONCLUSION This is the first report from Swefoot describing surgeon- and patient reported pre-operative data in patients with surgical treated HV.
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Affiliation(s)
- Ann-Charlott Söderpalm
- Capio Orthocenter, Gothenburg, Sweden; Department of Orthopedics and Clinical Sciences in Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden.
| | - Fredrik Montgomery
- Department of Orthopedics and Clinical Sciences in Malmö, Lund University, Sweden
| | - Katarina Nilsson Helander
- Department of Orthopedics and Clinical Sciences in Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden
| | - Maria C Cöster
- Department of Orthopedics and Clinical Sciences in Malmö, Lund University, Sweden; Department of Surgical Sciences, Uppsala University, Uppsala, Sweden; Capio Movement, Halmstad, Sweden
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Zhang Y, Ren J, Zang Y, Guo W, Disantis A, Martin RL. Cross-Culturally Adapted Versions of Patient Reported Outcome Measures for the Lower Extremity. Int J Sports Phys Ther 2023; V18:653-686. [PMID: 37425110 PMCID: PMC10324371 DOI: 10.26603/001c.74528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 03/08/2023] [Indexed: 07/11/2023] Open
Abstract
Background A large number of patient reported outcome measures (PROMs) have been developed in the English language for various lower extremity orthopaedic pathologies. Twenty different PROMs were recommended for 15 specific musculoskeletal lower extremity pathologies or surgeries. However, the availability of cross-culturally adapted versions of these recommended PROMs is unknown. Purpose The purpose of this study was to identify the cross-culturally adapted versions of recommended PROMs for individuals experiencing orthopedic lower extremity pathologies or undergoing surgeries, and to identify the psychometric evidence that supports their utilization. Study design Literature Review. Methods PubMed, Embase, Medline, Cochrane, CINAHL, SPORTDisucs and Scopus were searched for cross-culturally adapted translated studies through May 2022. The search strategy included the names of the 20 recommended PROMs from previous umbrella review along with the following terms: reliability, validity, responsiveness, psychometric properties and cross-cultural adaptation. Studies that presented a non-English language version of the PROM with evidence in at least one psychometric property to support its use were included. Two authors independently evaluated the studies for inclusion and independently extracted data. Results Nineteen PROMS had cross-culturally adapted and translated language versions. The KOOS, WOMAC, ACL-RSL, FAAM, ATRS, HOOS, OHS, MOXFQ and OKS were available in over 10 different language versions. Turkish, Dutch, German, Chinese and French were the most common languages, with each language having more than 10 PROMs with psychometric properties supporting their use. The WOMAC and KOOS were both available in 10 languages and had all three psychometric properties of reliability, validity, and responsiveness supporting their use. Conclusion Nineteen of the 20 recommended instruments were available in multiple languages. The PROM most frequently cross-culturally adapted and translated were the KOOS and WOMAC. PROMs were most frequently cross-culturally adapted and translated into Turkish. International researchers and clinicians may use this information to more consistently implement PROMs with the most appropriate psychometric evidence available to support their use. Level of evidence 3a.
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Affiliation(s)
- Yongni Zhang
- Rangos School of Health Sciences Duquesne- China Health Institute
| | - Jiayi Ren
- Shuguang Hospital of Shanghai University of Traditional Chinese Medicine
| | - Yaning Zang
- Department of Kinesiology Shanghai University of Sport
| | - Wenhao Guo
- Rangos School of Health Sciences Duquesne- China Health Institute
| | - Ashley Disantis
- Department of Physical Therapy Duquesne University
- UPMC Children's Hospital of Pittsburgh
| | - Robroy L Martin
- Department of Physical Therapy Duquesne University
- UPMC Center for Sports Medicine
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CÖSTER MC, BREMANDER A, NILSDOTTER A. Patient-reported outcome for 17,648 patients in 5 different Swedish orthopaedic quality registers before and 1 year after surgery: an observational study. Acta Orthop 2023; 94:1-7. [PMID: 36701121 PMCID: PMC9880767 DOI: 10.2340/17453674.2023.6577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND AND PURPOSE The EQ-5D is a patientreported outcome measure (PROM). To make priorities and allocate resources between patients and surgical procedures it is necessary to evaluate outcome differences, which is why comparing PROMs between registers is important. We compared EQ-5D data and the follow-up rate for selected diagnoses reported to Swedish orthopedic registers before and 1 year after surgery. PATIENTS AND METHODS Patients from 5 orthopedic registers (Swespine, Swedish Hip Arthroplasty Register, Swedish Knee Arthroplasty Register, Swedankle, and Swefoot) who, in 2014-2018, underwent surgery in southern Sweden were included in the study. Data on the EQ-5D index, individual questions, and the EQ-VAS at baseline and at the 1-year follow-up was compared. RESULTS 17,648 patients had completed the EQ-5D pre- and 1-year postoperatively. The follow-up rate ranged from 32% to 88%. All registers showed a statistical and clinically relevant improvement in the EQ-5D index (mean improvement 0.29-0.39), where patients who underwent hip arthroplasties experienced the largest improvement. The EQ-5D index improvements in patients with foot and ankle surgeries were larger than for patients with knee arthroplasties and spinal surgeries. The dimensions "self-care" and "usual activities" had the largest change in patients reporting "some problems." CONCLUSION All 5 registers showed a clinically relevant improvement 1 year postoperatively regarding the EQ-5D index, supporting continuous resource allocation to these groups of patients and surgical procedures. However, using PROM data to present register differences was challenged by the high number of non-responders.
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Affiliation(s)
- Maria C CÖSTER
- Departments of Orthopaedics and Clinical Sciences, Lund University, Malmö and Department of Orthopaedics, Uppsala University Hospital, Uppsala, Sweden
| | - Ann BREMANDER
- Departments of Rheumatology and Clinical Sciences Lund, Lund University, Lund, Sweden and Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Anna NILSDOTTER
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Cöster MC, Cöster A, Svensson F, Callréus M, Montgomery F. Swefoot - The Swedish national quality register for foot and ankle surgery. Foot Ankle Surg 2022; 28:1404-1410. [PMID: 35933290 DOI: 10.1016/j.fas.2022.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 07/14/2022] [Accepted: 07/19/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Population-based register data could be used to improve our knowledge of patients surgically treated for foot and ankle disorders. The quality register Swefoot was recently created to collect surgical and patient-reported data of foot and ankle surgery. This manuscript aims to describe the development and current use of the register. METHODS The development of Swefoot started in 2014 and currently, data on 16 different diagnoses are collected in 49 units performing foot and ankle surgery. Registrations are performed by the surgeon and the patient. RESULTS Between 2014 and 2020 approximately 20,000 surgical procedures have been registered. 75.1% of the registered patients were women, 9.3% were smokers, 9.3% had a concomitant rheumatoid disease, and 18.4% a BMI larger than 30 kg/m2. CONCLUSIONS: The Swefoot is a unique national register for foot and ankle surgery. It is by now possible to present demographic, surgical, and outcome parameters based on Swefoot.
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Affiliation(s)
- Maria C Cöster
- Departments of Orthopedics and Clinical Sciences, Lund University, Skåne University Hospital Malmö, Sweden; Center of Registers Västra Götaland, Sweden; Uppsala University Hospital, Sweden; Skåne University Hospital, Sweden.
| | | | - Fredrik Svensson
- Departments of Orthopedics and Clinical Sciences, Lund University, Skåne University Hospital Malmö, Sweden; Skåne University Hospital, Sweden
| | - Mattias Callréus
- Departments of Orthopedics and Clinical Sciences, Lund University, Skåne University Hospital Malmö, Sweden; Skåne University Hospital, Sweden
| | - Fredrik Montgomery
- Departments of Orthopedics and Clinical Sciences, Lund University, Skåne University Hospital Malmö, Sweden
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HENRICSON A, UNDÉN A, CARLSSON Å, JEHPSSON L, ROSENGREN B. Outcomes of trabecular metal total ankle replacement: a longitudinal observational cohort study of 239 consecutive cases from the Swedish Ankle Registry. Acta Orthop 2022; 93:689-695. [PMID: 35919022 PMCID: PMC9348131 DOI: 10.2340/17453674.2022.4387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND AND PURPOSE Information on outcomes after some modern total ankle replacement (TAR) designs is scarce. We therefore examined outcomes after trabecular metal (TM) TAR in Sweden by use of data from the national registry. PATIENTS AND METHODS On December 31, 2020, 239 primary TM TARs had been reported to the Swedish Ankle Registry. We analyzed prosthesis survival probability, using exchange or permanent extraction of components as endpoint for 239 protheses with mean follow-up of 2.2 years (0.1-6.6), risk of revision, as well as patient-reported outcome measures (SEFAS/EQ-5D/EQ-VAS) and satisfaction with surgery. RESULTS 7/239 prostheses (3%) had been revised by December 31, 2020. We found an overall prosthesis survival probability of 95% (95% CI 89-98) after 3 years. 2 years after surgery 81% of the answering patients were satisfied or very satisfied with surgery and patients reported median SEFAS 36 (max 48), EQ-5D 0.90 (max 1), and EQ-VAS 80 (max 100). INTERPRETATION We found short- to mid-term outcomes after TM TAR to be at least as good as after other TAR designs regarding prosthesis survival and patient-reported satisfaction.
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Affiliation(s)
- Anders HENRICSON
- Department of Orthopedics, Falu Central Hospital and Center of Clinical Research Dalecarlia, Falun
| | - Alexandra UNDÉN
- Department of Radiology, Skåne University Hospital, Malmö,Department of Clinical Sciences Malmö (IKVM), Lund University
| | - Åke CARLSSON
- Department of Clinical Sciences Malmö (IKVM), Lund University,Department of Orthopedics, Skåne University Hospital, Malmö, Sweden
| | - Lars JEHPSSON
- Department of Clinical Sciences Malmö (IKVM), Lund University,Department of Orthopedics, Skåne University Hospital, Malmö, Sweden
| | - Björn ROSENGREN
- Department of Clinical Sciences Malmö (IKVM), Lund University,Department of Orthopedics, Skåne University Hospital, Malmö, Sweden
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Pilskog K, Gote TB, Odland HEJ, Fjeldsgaard KA, Dale H, Inderhaug E, Fevang JM. Association of Delayed Surgery for Ankle Fractures and Patient-Reported Outcomes. Foot Ankle Int 2022; 43:762-771. [PMID: 35184581 PMCID: PMC9168892 DOI: 10.1177/10711007211070540] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Several studies probe the association between prolonged time to surgery and postoperative complications in ankle fractures, but little is known about how a longer wait time affects clinical outcomes. The present study aims to assess the association between time from injury to surgery and patient-reported outcomes after operative treatment of severe ankle fractures. METHOD Patients treated operatively for low-energy ankle fractures that also involve the posterior malleolus from 2014 to 2016 were included. Patient charts were reviewed for patient demographics, type of trauma, fracture characteristics, treatment given, and complications. Ankle function was evaluated on a follow-up visit by clinical examination, radiographs, and patient-reported outcome measures (Self-Reported Foot and Ankle Score [SEFAS], RAND-36, visual analog scale [VAS] of Pain, VAS of Satisfaction). We compared patients treated within 1 week to those treated later than a week from injury for analyses. RESULTS Follow-up visits of 130 patients were performed at mean 26 (SD 9) months after surgery. Patient demographics and fracture characteristics were similar between groups. Mean SEFAS was 34 (SD 10) in patients treated later than a week from injury vs 38 (SD 9) in those treated earlier (P = .012). Patients operated on later than 7 days from injury reported more pain (P = .008) and lower satisfaction than those treated earlier (P = .016). CONCLUSION In this retrospective patient series of low-energy ankle fractures with posterior malleolar fragments, we found that waiting >7 days for definitive surgery was associated with poorer clinical outcomes and more pain compared with those who had surgery earlier. LEVEL OF EVIDENCE Level III, retrospective comparative study.
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Affiliation(s)
- Kristian Pilskog
- Orthopedic department, Haukeland University Hospital, Norway,Clinical Institute 1, The University of Bergen,Kristian Pilskog, MD, Orthopedic Department, Haukeland University Hospital, Pb. 1400, Bergen, 5021, Norway.
| | | | | | | | - Håvard Dale
- Orthopedic department, Haukeland University Hospital, Norway,Clinical Institute 1, The University of Bergen
| | - Eivind Inderhaug
- Orthopedic department, Haukeland University Hospital, Norway,Clinical Institute 1, The University of Bergen
| | - Jonas Meling Fevang
- Orthopedic department, Haukeland University Hospital, Norway,Clinical Institute 1, The University of Bergen
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The Brazilian version of the Victorian Institute of Sport Assessment - Hamstring (VISA-H) Questionnaire: Translation, cross-cultural adaptation and measurement properties. Musculoskelet Sci Pract 2022; 58:102516. [PMID: 35114504 DOI: 10.1016/j.msksp.2022.102516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 01/16/2022] [Accepted: 01/19/2022] [Indexed: 11/21/2022]
Abstract
STUDY DESIGN Study of diagnostic accuracy/assessment scale. BACKGROUND Proximal hamstring tendinopathy (PHT) usually causes disability, deep pain in the proximal insertion of the tendon, and limitations in daily life and sports practice. Scales that assess PHT pain and disability may assist practitioners in their clinical decision-making processes. OBJECTIVES To perform a translation, cross-cultural adaptation and to evaluate the measurement properties of the Victorian Institute of Sport Assessment - Hamstring (VISA-H) questionnaire for the Brazilian population. METHODS The VISA-H was adapted to Brazilian Portuguese (VISA-H-Br) and applied in 2 occasions with 5-8-day intervals. The following measurement properties were evaluated: internal consistency, test-retest reliability, standard error of the measurement (SEM), smallest detectable change (SDC), structural validity, and construct validity. Ninety (n = 90) participants (40 PHT and 50 asymptomatic participants) were evaluated using the Lower Extremity Functional Scale (LEFS) and VISA-H. PHT was diagnosed via clinical examination. RESULTS The questionnaire was successfully translated, cross-culturally adapted, and renamed VISA-H-Br. The VISA-H-Br questionnaire demonstrated high internal consistency (Cronbach α = 0.96), excellent test-retest reliability (ICC = 0.90, CI 95% 0.83-0.93), and strong construct validity (rho = 0.692, p < 0.01 compared to LEFS). The SEM was 2.15 points, and the SDC was 5.96 points. No ceiling or floor effects were detected. CONCLUSION The Brazilian version of the VISA-H was consistent, reliable, and valid. Therefore, it may be used in clinical practice and research to assess the pain and disability of patients with PHT.
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Tapaninaho K, Uimonen MM, Saarinen AJ, Repo JP. Minimal important change for Foot and Ankle Outcome Score (FAOS). Foot Ankle Surg 2022; 28:44-48. [PMID: 33541758 DOI: 10.1016/j.fas.2021.01.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 12/20/2020] [Accepted: 01/20/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND Although Foot and Ankle Outcome Score (FAOS) is a widely used patient-reported outcome measure (PROM) for foot and ankle conditions, research on its longitudinal validity is still needed. Minimal important change (MIC) values for the FAOS were determined using predictive modeling. METHODS Overall, 134 patients that underwent operative treatment for foot and ankle conditions were included. An anchor based predictive logistic modeling method was used for estimating the MIC values for the FAOS subscales after surgery. RESULTS Mean score changes in the improved and the unimproved groups were 17.7 and 0.43 points for Pain, 3.9 and -3.3 points for Symptoms, 21.3 and 1.8 points for Activities and daily living (ADL), 8.7 and -2.8 points for Sport, and 12.5 and -3.3 points for quality of life subscale, respectively. MIC was successfully determined to four out of five subgroups as follows: Pain 9.5 (94% CI -6.4 to 24.6); ADL 11.7 (95% CI -19.6 to 46.6); Sport (95% CI -10.4 to 15.4); QoL 5.0 (95% CI -2.6 to 12.9). The Symptoms subgroup presented with low MIC of 0.3 (95% CI -11.7 to 13.4) fitting to the measurement error. CONCLUSION ADL, Sports, Pain, and QoL subscales of the FAOS presented logical MIC values. The MIC can be further evaluated for specific conditions.
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Affiliation(s)
- Krista Tapaninaho
- Department of Surgery, Central Finland Central Hospital, Jyväskylä, Finland.
| | - Mikko M Uimonen
- Department of Surgery, Central Finland Central Hospital, Jyväskylä, Finland
| | - Antti J Saarinen
- Department of Surgery, Central Finland Central Hospital, Jyväskylä, Finland
| | - Jussi P Repo
- Department of Orthopaedics and Traumatology, Tampere University Hospital, Tampere, Finland
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Meunier A, Palm L, Aspenberg P, Schilcher J. Antiresorptive treatment and talar collapse after displaced fractures of the talar neck: a long-term follow-up of 19 patients. Acta Orthop 2021; 92:455-460. [PMID: 33870825 PMCID: PMC8381918 DOI: 10.1080/17453674.2021.1915017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Background and purpose - Displaced fractures of the talar neck are associated with a high risk of structural collapse. In this observational analysis we hypothesized that pharmacological inhibition of osteoclast function might reduce the risk of structural collapse through a reduction in bone resorption during revascularization of the injured bone.Patients and methods - Between 2002 and 2014 we treated 19 patients with displaced fractures of the talar neck with open reduction and internal fixation. Of these, 16 patients were available for final follow-up between January and November 2017 (median 12 years, IQR 7-13). Among these, 6 patients with Hawkins type 3 fractures and 2 patients with Hawkins type 2b fractures received postoperative antiresorptive treatment (7 alendronate, 1 denosumab) for 6 to 12 months. The remaining 8 patients received no antiresorptive treatment. The self-reported foot and ankle score (SEFAS) was available in all patients and 15 patients had undergone computed tomography (CT) at final follow-up, which allowed evaluation of structural collapse of the talar dome and signs of post-traumatic osteoarthritis.Results - The risk for partial collapse of the talar dome was equal in the 2 groups (3 in each group) and post-traumatic arthritis was observed in all patients. The SEFAS in patients with antiresorptive treatment was lower, at 21 points (95% CI 15-26), compared with those without treatment, 29 points (CI 22-35).Interpretation - Following a displaced fracture of the talar neck, we found no effect of antiresorptive therapy on the rate of talar collapse, post-traumatic osteoarthritis, and patient-reported outcomes.
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Affiliation(s)
- Andreas Meunier
- Department of Orthopedics and Department of Biomedical and Clinical Sciences, Faculty of Health Science, Linköping University, Linköping; ,Correspondence:
| | - Lars Palm
- Department of Orthopedics and Department of Biomedical and Clinical Sciences, Faculty of Health Science, Linköping University, Linköping;
| | - Per Aspenberg
- Department of Orthopedics and Department of Biomedical and Clinical Sciences, Faculty of Health Science, Linköping University, Linköping;
| | - Jörg Schilcher
- Department of Orthopedics and Department of Biomedical and Clinical Sciences, Faculty of Health Science, Linköping University, Linköping; ,Wallenberg Centre for Molecular Medicine, Linköping University, Linköping, Sweden
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Hallux rigidus - Osteoarthritis of the first MTP-joint. Surgical and patient-reported results from Swefoot. Foot Ankle Surg 2021; 27:555-558. [PMID: 32859495 DOI: 10.1016/j.fas.2020.07.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 06/14/2020] [Accepted: 07/17/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND Swefoot is a Swedish national registry, that covers surgery in the foot and ankle. Surgical treatment of hallux rigidus (HR) vary within and between countries. The aim of this study was to report baseline variables for patients with HR. METHODS We extracted baseline characteristics, surgical procedures and patient-reported data for patients with HR entered in the registry during the period January 2014 to August 2019. RESULTS By August 2019, 1818 patients were reported in the registry. 68.9% of the patients were women, the average age was 58 years, the mean BMI was 26.4kg/m2. 41.9% of the patients underwent a cheilectomy,19.8% a metatarsal osteotomy, 34.3% a fusion, 0.2% an arthroplasty, 0.3% Keller's procedure and 3.5% other methods. The preoperative summary score for SEFAS (Self-reported Foot and Ankle Score) was 26 and for EQ-5D (Euroqol-5 Dimension) 0.60. CONCLUSION This study is the first report from Swefoot regarding HR.
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Erichsen JL, Jensen C, Larsen MS, Damborg F, Viberg B. Danish translation and validation of the Self-reported foot and ankle score (SEFAS) in patients with ankle related fractures. Foot Ankle Surg 2021; 27:521-527. [PMID: 32980265 DOI: 10.1016/j.fas.2020.06.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 06/22/2020] [Accepted: 06/26/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND The Self-reported Foot and Ankle Score (SEFAS) is a patient-reported outcome measure used to evaluate foot and ankle disorders. The purpose of this study was to translate, cross-culturally adapt and validate the Danish language version of the SEFAS in patients with ankle-related fractures. METHODS Forward-backward translation, cross-cultural adaption and validation were performed. In total, 125 patients completed the SEFAS-DK and the Danish version of American Orthopaedic Foot and Ankle Score (AOFAS-DK) at three time points after the date of fracture. The evaluation was performed according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines. RESULTS The intra-class correlation coefficient (ICC) level of the SEFAS-DK total score was 0.93 (95% confidence interval [CI]: 0.88-0.96). Cronbach's alpha (CA) for the SEFAS-DK was 0.93, while the floor and ceiling effect at week 6 post-injury was 22.4%. Construct validity was correlated with the AOFAS, and >75% of the pre-defined hypotheses could be confirmed. Responsiveness was analysed using longitudinal data. The minimal clinical important change (MCIC) showed that the SEFAS-DK detects changes in physical function over time. CONCLUSION The Danish version of the SEFAS showed overall good reliability, validity and responsiveness. SEFAS-DK can be used to evaluate physical function in patients with ankle-related fractures. LEVEL OF EVIDENCE level II, prospective cohort study.
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Affiliation(s)
- J L Erichsen
- Department of Orthopedic Surgery and Traumatology, Lillebaelt Hospital - University Hospital of Southern, Sygehusvej 24, 6000 Kolding Denmark; Department of Orthopedic Surgery and Traumatology, Odense University Hospital, J.B Winsløvvej 15, 5000, Odense, Denmark; Institute of Clinical Research, University of Southern, J.B Winsløvvej 19.3, 5000 Odense Denmark.
| | - C Jensen
- Department of Orthopedic Surgery and Traumatology, Lillebaelt Hospital - University Hospital of Southern, Sygehusvej 24, 6000 Kolding Denmark; Institute of Regional Health Research, University of Southern, J.B Winsløvvej 19.3, 5000 Odense Denmark
| | - M S Larsen
- Department of Orthopedic Surgery and Traumatology, Odense University Hospital, J.B Winsløvvej 15, 5000, Odense, Denmark; Institute of Clinical Research, University of Southern, J.B Winsløvvej 19.3, 5000 Odense Denmark
| | - F Damborg
- Department of Orthopedic Surgery and Traumatology, Lillebaelt Hospital - University Hospital of Southern, Sygehusvej 24, 6000 Kolding Denmark
| | - B Viberg
- Department of Orthopedic Surgery and Traumatology, Lillebaelt Hospital - University Hospital of Southern, Sygehusvej 24, 6000 Kolding Denmark; Department of Orthopedic Surgery and Traumatology, Odense University Hospital, J.B Winsløvvej 15, 5000, Odense, Denmark; Institute of Regional Health Research, University of Southern, J.B Winsløvvej 19.3, 5000 Odense Denmark
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Erichsen J, Froberg L, Viberg B, Damborg F, Jensen C. Danish Language Version of the American Orthopedic Foot and Ankle Society Ankle-Hindfoot Scale (AOFAS-AHS) in Patients with Ankle-Related Fractures. J Foot Ankle Surg 2021; 59:657-663. [PMID: 32307287 DOI: 10.1053/j.jfas.2019.08.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 08/26/2019] [Accepted: 08/27/2019] [Indexed: 02/03/2023]
Abstract
The American Orthopedic Foot and Ankle Society Ankle-Hindfoot Scale (AOFAS-AHS) is, to date, the most widely used scale for evaluating foot and ankle disorders. We translated it into Danish and evaluated the reliability, validity and responsiveness of the Danish version of the AOFAS-AHS (AOFAS-DK) in patients aged >18 years with isolated ankle-related fractures. Forward-backward translation, cross-cultural adaption, and validation study were performed. In total, 125 patients completed the AOFAS-DK and the Self-reported Foot and Ankle Score (SEFAS) at 3 time points after the date of fracture. The evaluation was performed according to the Consensus-based Standards for the selection of health Measurement Instruments guidelines. The intra-class correlation coefficient level of the AOFAS-DK total score was 0.87 (95% confidence interval: 0.80-0.91). Cronbach's alpha (CA) for the AOFAS-DK function subscale was 0.62, whereas the floor and ceiling effect of the function subscale was 32% (T1) and 19% (T2), respectively. Construct validity was correlated with the SEFAS, and >75% of the predefined hypotheses could be confirmed. Responsiveness was analyzed using longitudinal data, and showed that the AOFAS-DK can detect changes in scores. The Danish version of the self-administered section of the AOFAS-AHS showed overall good reliability, validity, and responsiveness. The low CA values and the presence of the floor effect might be due to the low number of items and response options available in the scale. The AOFAS-DK can be used to evaluate physical function in patients with ankle-related fractures.
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Affiliation(s)
- Julie Erichsen
- Senior Registrar, Department of Orthopedic Surgery and Traumatology, Kolding Hospital, a part of Lillebaelt Hospital, Kolding, Denmark; Consultant and Associate Professor, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
| | - Lonnie Froberg
- Consultant and Associate Professor, Department of Orthopedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark; Consultant and Associate Professor, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Bjarke Viberg
- Senior Registrar, Department of Orthopedic Surgery and Traumatology, Kolding Hospital, a part of Lillebaelt Hospital, Kolding, Denmark; Associate Professor, Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Frank Damborg
- Consultant, Department of Orthopedic Surgery and Traumatology, Kolding Hospital, a part of Lillebaelt Hospital, Kolding, Denmark
| | - Carsten Jensen
- Senior Registrar, Department of Orthopedic Surgery and Traumatology, Kolding Hospital, a part of Lillebaelt Hospital, Kolding, Denmark; Associate Professor, Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
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Pilskog K, Gote TB, Odland HEJ, Fjeldsgaard KA, Dale H, Inderhaug E, Fevang JM. Traditional Approach vs Posterior Approach for Ankle Fractures Involving the Posterior Malleolus. Foot Ankle Int 2021; 42:389-399. [PMID: 33203272 PMCID: PMC8054166 DOI: 10.1177/1071100720969431] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND In the past, posterior malleolus fragments (PMFs) commonly have been indirectly reduced and fixed when fragments involve 25% or more of the tibial articular surface, while smaller fragments were left unfixed. The posterior approach has become increasingly popular and allows fixation of even smaller fragments. This study compares clinical outcome for the 2 treatment strategies. METHODS Patients with ankle fractures involving a PMF treated from 2014 to 2016 were eligible for inclusion. Patients were allocated to group A (treated with a posterior approach) or group B (treated with the traditional approach) according to the treatment given. A one-to-one matching of patients from each group based on the size of the PMF was performed. Patient charts were reviewed, and outcome evaluation was performed clinically, radiographically, and by patient-reported outcome measures (PROMs; Self-Reported Foot and Ankle Score, RAND-36, visual analog scale [VAS] of pain, and VAS of satisfaction). Forty-three patients from each group were matched. Median follow-up was 26 (interquartile range [IQR], 19-35) months postoperatively. RESULTS The median PMF size was 17% (IQR, 12-24) in both groups, and they reported similar results in terms of PROMs. Fixation of the PMF was performed in 42 of 43 (98%) patients in group A and 7 of 43 (16%) patients in group B (P < .001). The former group more frequently got temporary external fixation (56% vs 12%, P < .01) and less frequently had syndesmotic fixation (14% vs 49%, P < .01), and they had less mechanical irritation and hardware removal but more noninfectious skin problems (28% vs 5%, P < .01). Median time from injury to definitive surgery (8 vs 0 days, P < .001) and median length of stay (12 vs 3 days, P < .001) were longer in group A. CONCLUSION Comparison of treatment strategies for ankle fractures involving the posterior malleolus showed similar results between patients treated with a traditional approach and a posterior approach. LEVEL OF EVIDENCE Level III, retrospective comparative study.
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Affiliation(s)
- Kristian Pilskog
- Orthopedic Department, Haukeland
University Hospital, Bergen, Norway,Kristian Pilskog, MD, Orthopedic Department,
Haukeland University Hospital, Postbox 1400, 5021, Bergen, Norway.
| | - Teresa Brnic Gote
- Department of Physiotherapy, Haukeland
University Hospital, Bergen, Norway
| | | | | | - Håvard Dale
- Orthopedic Department, Haukeland
University Hospital, Bergen, Norway
| | - Eivind Inderhaug
- Orthopedic Department, Haukeland
University Hospital, Bergen, Norway
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Minimal important change for the visual analogue scale foot and ankle (VAS-FA). Foot Ankle Surg 2021; 27:196-200. [PMID: 32444340 DOI: 10.1016/j.fas.2020.04.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 03/28/2020] [Accepted: 04/12/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND Visual analogue scale foot and ankle (VAS-FA) is a patient-reported outcome measure for foot and ankle disorders. The VAS-FA is validated into several languages and well adopted into use. Nonetheless, minimal important change (MIC) for the VAS-FA has not been estimated thus far. METHODS The VAS-FA score was obtained from 106 patients undergoing surgery for various foot and ankle complaints. MIC was estimated using an anchor-based predictive method. RESULTS The adjusted MIC was 6.8 for total VAS-FA score, and 9.3 for the Pain, 5.8 for the Function, and 5.7 for the Other complaints subscales. The VAS-FA score was found to separate improvement and deterioration in patients' foot and ankle condition. CONCLUSIONS MIC was successfully defined for the VAS-FA in the current study. The VAS-FA can be used to evaluate foot and ankle patients' clinical foot and ankle status and its change. Further research on estimating disease-specific MICs is recommended.
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Cöster ME, Montgomery F, Cöster MC. Patient-reported outcomes of joint-preserving surgery for moderate hallux rigidus: a 1-year follow-up of 296 patients from Swefoot. Acta Orthop 2021; 92:109-113. [PMID: 32972279 PMCID: PMC7919882 DOI: 10.1080/17453674.2020.1824762] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Background and purpose - Hallux rigidus (HR) may cause decreased range of motion, joint pain, and gait disturbances. There is a lack of evidence regarding the outcome of different surgical procedures for moderate HR. We report patient-reported outcomes after joint-preserving surgical procedures for moderate HR.Patients and methods - We included 296 patients registered in Swefoot (Swedish national registry of foot and ankle surgery) who underwent primary surgery for moderate HR 2014 through 2018. We extracted information on anthropometrics, grading of HR, chosen surgical procedure, and patient-reported data including the PROMs SEFAS (summary score 0-48) and EQ-5D-3L (index 0-1) preoperatively and 1 year postoperatively.Results - 115 patients underwent metatarsal decompression (i.e., Youngswick) osteotomy (YOT) and 181 underwent cheilectomy. The mean improvement in SEFAS score 1 year after surgery was 12 points (95% CI 10 - 13) for YOT and 10 points (CI 9 - 12) for cheilectomy. Also, EQ-5D improved in both groups. Patients who underwent YOT were more satisfied with the procedure (84% vs. 70% for cheilectomy, p = 0.02).Interpretation - Surgically treated patients with moderate HR improved after both YOT and cheilectomy, according to patient-reported data from Swefoot. Patients who underwent a YOT were more satisfied with their procedure. One possible explanation may be that more patients in the YOT group had a concomitant hallux valgus; however, we have no information on this.
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Affiliation(s)
- Marcus E Cöster
- Department of Clinical Sciences, Lund University; ,Department of Orthopedics, Central Hospital in Växjö; ,Correspondence:
| | | | - Maria C Cöster
- Department of Clinical Sciences, Lund University; ,Department of Orthopedics, Skåne University Hospital in Malmö, Sweden
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16
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Whittaker GA, Munteanu SE, Roddy E, Menz HB. Measures of Foot Pain, Foot Function, and General Foot Health. Arthritis Care Res (Hoboken) 2020; 72 Suppl 10:294-320. [PMID: 33091250 DOI: 10.1002/acr.24208] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 04/02/2020] [Indexed: 12/26/2022]
Affiliation(s)
- Glen A Whittaker
- School of Allied Health, Human Services and Sport, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
| | - Shannon E Munteanu
- School of Allied Health, Human Services and Sport, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
| | - Edward Roddy
- Primary Care Centre Versus Arthritis, Chesterfield, UK, School of Primary, Community and Social Care, Keele University, Keele, UK, and Haywood Academic Rheumatology Centre, Midland Partnership NHS Foundation Trust, Stoke-on-Trent, UK
| | - Hylton B Menz
- School of Allied Health, Human Services and Sport, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
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Validity and internal consistency of the American Orthopaedic Foot and Ankle Society Midfoot Scale in patients with Lisfranc injury. Foot Ankle Surg 2020; 26:523-529. [PMID: 31255577 DOI: 10.1016/j.fas.2019.06.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 05/21/2019] [Accepted: 06/09/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND The American Orthopaedic Foot and Ankle Society (AOFAS) Midfoot Scale is an extensively used outcome measure instrument for evaluating outcomes after foot and ankle surgery or trauma. METHODS In total, 117 patients with Lisfranc injury completed the AOFAS Midfoot Scale and the Visual Analogue Scale Foot and Ankle (VAS-FA) instruments. Internal consistency (correlation between different items), floor and ceiling values, convergent validity, item threshold distribution, and the coverage (item difficulty) of the AOFAS Midfoot scale were tested. RESULTS AOFAS Midfoot Scale had high convergent validity and acceptable internal consistency (Cronbach's alpha >0.70). The ceiling effect was confirmed. The person-item distribution indicated that the scale had a lack of coverage and targeting in our sample. CONCLUSIONS Our data suggests that the AOFAS Midfoot Scale has acceptable validity and internal consistency. However, due to the lack of coverage and targeting, it should not be the primary outcome measure to be used to evaluate the outcomes after Lisfranc injury in the future studies.
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Voortman M, Beekman E, Drent M, Hoitsma E, De Vries J. Determination of the smallest detectable change (SDC) and the minimal important difference (MID) for the Small Fiber Neuropathy Screening List (SFNSL) in sarcoidosis. SARCOIDOSIS VASCULITIS AND DIFFUSE LUNG DISEASES 2020; 35:333-341. [PMID: 32476921 PMCID: PMC7170121 DOI: 10.36141/svdld.v35i4.7260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 08/24/2018] [Indexed: 12/25/2022]
Abstract
Background: Previous studies found that 40-60% of the sarcoidosis patients suffer from small fiber neuropathy (SFN), substantially affecting quality of life. SFN is difficult to diagnose, as a gold standard is still lacking. The need for an easily administered screening instrument to identify sarcoidosis-associated SFN symptoms led to the development of the SFN Screening List (SFNSL). The usefulness of any questionnaire in clinical management and research trials depends on its interpretability. Obtaining a clinically relevant change score on a questionnaire requires that the smallest detectable change (SDC) and minimal important difference (MID) are known. Objectives: The aim of this study was to determine the SDC and MID for the SFNSL in patients with sarcoidosis. Methods: Patients with neurosarcoidosis and/or sarcoidosis-associated SFN symptoms (N=138) included in the online Dutch Neurosarcoidosis Registry participated in a prospective, longitudinal study. Anchor-based and distribution-based methods were used to estimate the MID and SDC, respectively. Results: The SFNSL was completed both at baseline and at 6-months’ follow-up by 89/138 patients. A marginal ROC curve (0.6) indicated cut-off values of 3.5 points, with 73% sensitivity and 49% specificity for change. The SDC was 11.8 points. Conclusions: The MID on the SFNSL is 3.5 points for a clinically relevant change over a 6-month period. The MID can be used in the follow-up and management of SFN-associated symptoms in patients with sarcoidosis, though with some caution as the SDC was found to be higher. (Sarcoidosis Vasc Diffuse Lung Dis 2018; 35: 333-341)
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Affiliation(s)
- Mareye Voortman
- ILD Center of Excellence, Department of Pulmonology, St. Antonius Hospital, Nieuwegein, The Netherlands.,Department of Pulmonology, Division of Heart & Lungs, University Medical Centre Utrecht, The Netherlands.,ild care foundation research team, Ede, The Netherlands
| | - Emmylou Beekman
- Research Centre for Autonomy and Participation of Persons with a Chronic Illness, Zuyd University of Applied Sciences, Heerlen, The Netherlands.,Physiotherapy-multidisciplinary centre, ParaMedisch Centrum Zuid, Sittard, The Netherlands.,Department of Family Medicine, CAPHRI School for Public Health and Primary care, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Marjolein Drent
- ILD Center of Excellence, Department of Pulmonology, St. Antonius Hospital, Nieuwegein, The Netherlands.,Department of Pharmacology and Toxicology, FHML, Maastricht University, Maastricht, The Netherlands.,ild care foundation research team, Ede, The Netherlands
| | - Elske Hoitsma
- Department of Neurology, Alrijne Hospital, Leiden, The Netherlands
| | - Jolanda De Vries
- ild care foundation research team, Ede, The Netherlands.,Department of Medical Psychology, Elisabeth-TweeSteden Hospital Tilburg, Tilburg, The Netherlands.,Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
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Bull C, Byrnes J, Hettiarachchi R, Downes M. A systematic review of the validity and reliability of patient-reported experience measures. Health Serv Res 2019; 54:1023-1035. [PMID: 31218671 PMCID: PMC6736915 DOI: 10.1111/1475-6773.13187] [Citation(s) in RCA: 109] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES To identify patient-reported experience measures (PREMs), assess their validity and reliability, and assess any bias in the study design of PREM validity and reliability testing. DATA SOURCES/STUDY SETTING Articles reporting on PREM development and testing sourced from MEDLINE, CINAHL and Scopus databases up to March 13, 2018. STUDY DESIGN Systematic review. DATA COLLECTION/EXTRACTION METHODS Critical appraisal of PREM study design was undertaken using the Appraisal tool for Cross-Sectional Studies (AXIS). Critical appraisal of PREM validity and reliability was undertaken using a revised version of the COSMIN checklist. PRINCIPAL FINDINGS Eighty-eight PREMs were identified, spanning across four main health care contexts. PREM validity and reliability was supported by appropriate study designs. Internal consistency (n = 58, 65.2 percent), structural validity (n = 49, 55.1 percent), and content validity (n = 34, 38.2 percent) were the most frequently reported validity and reliability tests. CONCLUSIONS Careful consideration should be given when selecting PREMs, particularly as seven of the 10 validity and reliability criteria were not undertaken in ≥50 percent of the PREMs. Testing PREM responsiveness should be prioritized for the application of PREMs where the end user is measuring change over time. Assessing measurement error/agreement of PREMs is important to understand the clinical relevancy of PREM scores used in a health care evaluation capacity.
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Affiliation(s)
- Claudia Bull
- Centre for Applied Health Economics (CAHE)Griffith UniversityBrisbaneQueenslandAustralia
- Menzies Health Institute Queensland (MHIQ)BrisbaneQueenslandAustralia
| | - Joshua Byrnes
- Centre for Applied Health Economics (CAHE)Griffith UniversityBrisbaneQueenslandAustralia
- Menzies Health Institute Queensland (MHIQ)BrisbaneQueenslandAustralia
| | - Ruvini Hettiarachchi
- Centre for Applied Health Economics (CAHE)Griffith UniversityBrisbaneQueenslandAustralia
- Menzies Health Institute Queensland (MHIQ)BrisbaneQueenslandAustralia
| | - Martin Downes
- Centre for Applied Health Economics (CAHE)Griffith UniversityBrisbaneQueenslandAustralia
- Menzies Health Institute Queensland (MHIQ)BrisbaneQueenslandAustralia
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Comparative outcomes of foot cast and short leg cast in pseudo-Jones avulsion fracture: a single blinded randomized controlled trial. J Foot Ankle Res 2019; 12:47. [PMID: 31516558 PMCID: PMC6734469 DOI: 10.1186/s13047-019-0359-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 09/04/2019] [Indexed: 11/10/2022] Open
Abstract
Background Fractures of the metatarsal bones account for 35% of all foot fractures. Conservative management of fractures proximal to the metaphyseal-diaphyseal junction of the fifth metatarsal bone (pseudo-Jones) is by protected weight bearing. The methods of protected weight bearing include short-leg casting and splinting (boot cast, Jones's bandage and elastic bandage). However, currently there is no consensus as to which method is the most suitable. Method We have conducted a randomized controlled trial to compare outcomes of foot casting (FC) and short leg casting (SLC) to assess pain, function and complication outcomes for the treatment of pseudo-jones metatarsal fractures. This single-center, single blind,randomized controlled trial was conducted between 1 June 2016-1 July 2018 at Police General Hospital, Bangkok, Thailand. Result A total of 72 pseudo-jones metatarsal fracture participants were randomly allocated to treatment by foot cast or short leg cast. The primary outcomes were pain VAS, AOFAS and complications measured at 2, 4, 6 and 8 weeks after receiving the treatment. Seventy-two patients (36 paticipants per group) were enrolled to receive either FC or SLC. The mean VAS measured at baseline, 2 weeks, 4 weeks, 6 weeks and 8 weeks were 7.36, 1.97, 0.58, 0.17 and 0.08 respectively in the FC group; and 6.09, 2.91, 1.23, 0.37 and 0.11 respectively in the SLC group. The mean AOFAS at baseline, 2, 4, 6 and 8 weeks were 33.60, 68.22, 82.72, 91.75 and 98.11 respectively in the FC group; and 32.60, 60.20, 70.20, 92.24 and 99.13 in the SLC group. The estimated mean difference of pain VAS and AOFAS at 2 weeks and 4 weeks were - 0.94 (95% CI: - 1.53, - 0.34), - 0.65 (95%CI: - 1.24, - 0.05), 8.02 (95%CI: 3.74, 12.10) and 12.52 (95%CI: 8.27, 16.78), which were statistically significantly better in the FC groups when compared to the SLC groups. However, there were no statistically significant difference between the two groups at 6 and 8 weeks. Conclusion This study demonstrated that the application of foot casting can improve pain VAS and AOFAS function at 2 and 4 weeks in the treatment of pseudo-jones metatarsal fractures when compared to short leg casting. However, at 6 and 8 weeks, there were no statistically significantly different between the two groups.
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21
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Nilsdotter AK, Cöster ME, Bremander A, Cöster MC. Patient-reported outcome after hallux valgus surgery - a two year follow up. Foot Ankle Surg 2019; 25:478-481. [PMID: 30321964 DOI: 10.1016/j.fas.2018.02.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 11/15/2017] [Accepted: 02/27/2018] [Indexed: 02/04/2023]
Abstract
BACKGROUND Patients with hallux valgus deformity may require surgery but prospective patient-reported data is scarce. METHODS We evaluated 53 patients with a mean age of 55.3years (SD 14.1, 50 women), who underwent surgery due to hallux valgus. They completed the PROMs SEFAS, EQ-5D and SF-36 before and 6, 12 and 24 months after surgery. RESULTS All patient-reported outcomes improved at 6, 12 and 24months compared with the preoperative status. The greatest improvement occurred at 6months: SEFAS Δ 10.0 (95% confidence interval 7.8-12.2), EQ-5D Δ 0.22 (0.15-0.29), EQ-VAS Δ 8.4 (4.4-12.4), PF SF-36 Δ 22.0 (14.6-29.3) and BP SF-36 Δ 30.6 (23.1-38.1). CONCLUSIONS Hallux valgus surgery considerably reduced pain and improved function already within 6months after surgery. The improvement between 6 and 24months' follow-up was minimal measured with PROMs. LEVEL OF CLINICAL EVIDENCE III - prospective observational cohort study.
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Affiliation(s)
- A-K Nilsdotter
- Departments of Orthopedics and Clinical Sciences, Lund University, Skåne University Hospital Malmö, Sweden; Department of R&D, Sahlgrenska University Hospital Göteborg, Sweden
| | - M E Cöster
- Departments of Orthopedics and Clinical Sciences, Lund University, Skåne University Hospital Malmö, Sweden
| | - A Bremander
- Departments of Rheumatology and Clinical Sciences Lund, Lund University, Lund, Sweden,; School of Business, Engineering and Science, Halmstad University, Halmstad, Sweden
| | - M C Cöster
- Departments of Orthopedics and Clinical Sciences, Lund University, Skåne University Hospital Malmö, Sweden.
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Cöster MC, Rosengren BE, Karlsson MK, Carlsson Å. Age- and Gender-Specific Normative Values for the Self-Reported Foot and Ankle Score (SEFAS). Foot Ankle Int 2018; 39:1328-1334. [PMID: 30035614 DOI: 10.1177/1071100718788499] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND The Self-Reported Foot and Ankle Score (SEFAS) is a foot- and ankle-specific patient-reported outcome measurement (PROM) score that has been validated with good results for a variety of foot and ankle disorders. SEFAS is sensitive detecting improvement or deterioration after surgery. However, normative values, required to put a specific patient's summary score into perspective, are lacking. METHODS In this report, we included 396 population-based men and 383 women (43% of the invited individuals), age 20-89 years, who had completed the SEFAS questionnaire and questions regarding anthropometrics and health. We used Mann-Whitney U test to test gender differences and Spearman correlation coefficients to determine any association between SEFAS score and age. We present gender-specific median SEFAS scores with range and 5th to 95th percentiles and mean with standard deviation. RESULTS The SEFAS normative values were median 48 in men (range 11-48), 5th to 95th percentiles 31 to 48 and mean 45 ± 6, and in women, median 47 (range 6-48), 5th to 95th percentiles 23 to 48 and mean 43 ± 8 (gender comparison P < .001). SEFAS normative values correlated inversely with age (r = -0.12, P < .001). CONCLUSION In the general population, older age was associated with lower SEFAS value, and men had higher values than women. The population-based normative SEFAS values provided in this study can facilitate quantification of disability related to foot and ankle with and without surgery in the foot and ankle. LEVEL OF EVIDENCE Level II, prospective comparative study.
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Affiliation(s)
- Maria C Cöster
- 1 Department of Orthopaedics and Clinical Sciences, Lund University, Skåne University Hospital in Malmö, Sweden
| | - Björn E Rosengren
- 1 Department of Orthopaedics and Clinical Sciences, Lund University, Skåne University Hospital in Malmö, Sweden
| | - Magnus K Karlsson
- 1 Department of Orthopaedics and Clinical Sciences, Lund University, Skåne University Hospital in Malmö, Sweden
| | - Åke Carlsson
- 1 Department of Orthopaedics and Clinical Sciences, Lund University, Skåne University Hospital in Malmö, Sweden
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Kamrad I, Carlsson Å, Henricson A, Magnusson H, Karlsson MK, Rosengren BE. Good outcome scores and high satisfaction rate after primary total ankle replacement. Acta Orthop 2017; 88:675-680. [PMID: 28812410 PMCID: PMC5694814 DOI: 10.1080/17453674.2017.1366405] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Background and purpose - Total ankle replacement (TAR) is gaining popularity for treatment of end-stage ankle arthritis. Large patient-centered outcome studies are, however, few. Here, we report data from the Swedish Ankle Registry. Patients and methods - We examined outcomes after primary TAR in patients from the Swedish Ankle Registry using PROMs (Patient Reported Outcome Measures; generic: EQ-5D and SF-36, region specific: SEFAS (Self-Reported Foot and Ankle Score), and a question on satisfaction). We included 241 patients registered with primary TAR between 2008 and 2016 and who completed PROMs preoperatively and postoperatively up to 24 months. We evaluated changes in PROMs following surgery and estimated effects of age, diagnosis, prosthetic design, and preoperative functional score on the outcomes. Results - All absolute scores improved from preoperative to 24 months after surgery (p ≤ 0.001). 71% of the patients were satisfied or very satisfied at the latest follow-up and 12% dissatisfied or very dissatisfied. Postoperative SEFAS correlated with age (r = 0.2, p = 0.01) and preoperative SEFAS (r = 0.3, p < 0.001), as did patient satisfaction (r = -0.2; p ≤ 0.03). Postoperative SEFAS and EQ-5D were similar between different diagnoses or prosthetic designs. Preoperative SF-36 was associated with diagnosis (p ≤ 0.03), postoperative SF-36 with age (r = 0.2, p = 0.01) and diagnosis (p < 0.03). Interpretation - We found statistically and clinically significant improvements in patient-reported outcomes following TAR surgery. The postoperative region-specific SEFAS was positively associated with older age. Prosthetic design seemed not to influence patient-reported outcome, whereas diagnosis partly did. Studies with longer follow-up are necessary to establish the long-term outcome of TAR and to elucidate whether short- and mid-term outcomes may predict implant failure.
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Affiliation(s)
- Ilka Kamrad
- Departments of Orthopedics and Clinical Sciences, Lund University and Skåne University Hospital, Malmö,Correspondence:
| | - Åke Carlsson
- Departments of Orthopedics and Clinical Sciences, Lund University and Skåne University Hospital, Malmö
| | - Anders Henricson
- Department of Orthopedics, Falu Central Hospital and Centre for Clinical Research Dalarna, Falun, Sweden
| | - Håkan Magnusson
- Departments of Orthopedics and Clinical Sciences, Lund University and Skåne University Hospital, Malmö
| | - Magnus K Karlsson
- Departments of Orthopedics and Clinical Sciences, Lund University and Skåne University Hospital, Malmö
| | - Björn E Rosengren
- Departments of Orthopedics and Clinical Sciences, Lund University and Skåne University Hospital, Malmö
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