AOFAS Position Statement Regarding Patient-Reported Outcome Measures

Kitaoka, Harold B.; Meeker, James E.; Phisitkul, Phinit; Adams, Samuel B.; Kaplan, Jonathan; Wagner, Emilio

doi:10.1177/1071100718809066

Cited by 68 publications

(59 citation statements)

References 34 publications

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“…The AOFAS-AHS is a clinician-based outcome measure, which lacks sufficient reliability, validity and numeric threshold for a clinically significant difference [74].…”

Section: Discussionmentioning

confidence: 99%

Operative versus nonoperative treatment in children with painful rigid flatfoot and talocalcaneal coalition

Gennaro

Stallone

Olivotto

et al. 2020

BMC Musculoskelet Disord

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Background: The management of painful rigid flatfoot (RFF) with talocalcaneal coalition (TCC) is controversial. We aimed to compare operative and nonoperative treatment in children with RFF and TCC. Methods: We retrospectively reviewed medical records and radiographs of children with RFF and TTC treated between 2005 and 2015. The nonoperative treatment consisted of manipulation under anesthesia, cast immobilization and shoe insert after cast removal. The operative treatment consisted of combined TCC resection, graft interposition and subtalar arthroereisis. Results: Thirty-four children (47 ft) in the nonoperative group and twenty-one children (34 ft) in the operative group were included. No differences were found between groups, concerning baseline characteristics. The mean age at treatment was 11.8 years (9-17): 11.6 (9-17) for the nonoperative group, 12.2 (10-15) for the operative group. The mean follow-up averaged 6.6 (3-12) years and was significantly longer in the nonoperative group (7.8 versus 4.7 years; p < 0.0005), since the operative procedure was increasingly practiced in the latest years. There were no complications in either groups, but 6 patients (7 ft) in the nonoperative group were unsatisfied and required surgery. At the latest follow-up, the AOFAS-AHS improved in both groups, although the operative group showed significantly better improvement. The operative group reported also significantly better FADI score, after adjustment for follow-up and baseline variables. Conclusion: The operative treatment showed better results compared to the nonoperative treatment. Symptomatic RFF with TCC in children can be effectively treated in one step with resection, graft interposition and subtalar arthroereisis. Further prospective randomized studies are needed to confirm our findings and to identify the best operative strategy in this condition.

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“…The AOFAS-AHS is a clinician-based outcome measure, which lacks sufficient reliability, validity and numeric threshold for a clinically significant difference [74].…”

Section: Discussionmentioning

confidence: 99%

Operative versus nonoperative treatment in children with painful rigid flatfoot and talocalcaneal coalition

Gennaro

Stallone

Olivotto

et al. 2020

BMC Musculoskelet Disord

View full text Add to dashboard Cite

show abstract

“…The AOFAS-AHS is a clinician-based outcome measure, which lacks sufficient reliability, validity and numeric threshold for a clinically significant difference. (74) To overcome this issue, we administered the FADI at the latest visit, but the lack of a preoperative patient-reported measure limits any consideration about the real effectiveness of both treatments from the patient's perspective. The study compared two possible ways to manage RFF and TCC, thus it cannot completely answer to some important questions such as the role of manipulation over just immobilization, the risk-effectiveness and cost-effectiveness of the anesthesia, the effect of the arthroereisis over just resection and the comparison with other surgical procedures, such as osteotomies.…”

Section: Discussionmentioning

confidence: 99%

Operative versus nonoperative treatment in children with painful rigid flatfoot and talocalcaneal coalition. Results from a retrospective comparative study.

Gennaro

Stallone

Olivotto

et al. 2020

Preprint

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Background: The management of painful rigid flatfoot (RFF) with talocalcaneal coalition (TCC) is controversial. We aimed to compare operative and nonoperative treatment in children with RFF and TCC. Methods: We retrospectively reviewed medical records and radiographs of children with RFF and TTC treated between 2005 and 2015. The nonoperative treatment consisted of manipulation under anesthesia, cast immobilization and shoe insert after cast removal. The operative treatment consisted of combined TCC resection, graft interposition and subtalar arthroereisis. Results: Thirty-four Children (47 feet) in the nonoperative group and twenty-one children (34 feet) in the operative group were included. No differences were found between groups, concerning baseline characteristics. The mean age at treatment was 11.8 years (9-17): 11.6 (9-17) for the nonoperative group, 12.2 (10-15) for the operative group. The mean follow-up averaged 6.6 (3-12) years and was significantly longer in the nonoperative group (7.8 versus 4.7 years; p < 0.0005), since the operative procedure was increasingly practiced in the latest years. There were no complications in either groups, but 6 patients (7 feet) in the nonoperative group were unsatisfied and required surgery. At the latest follow-up, the AOFAS-AHS improved in both groups, although the operative group showed significantly better improvement. The operative group reported also significantly better FADI score, after adjustment for follow-up and baseline variables. Conclusions: The operative treatment showed better results compared to the nonoperative treatment. Symptomatic RFF with TCC in children can be effectively treated in one step with resection, graft interposition and subtalar arthroereisis. Further prospective randomized studies are needed to confirm our findings and to identify the best operative strategy in this condition.

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“…When different lower-extremity PROMs (including the WOMAC and the LEFS) were used among patients with ankle osteoarthritis, none of the PROMs captured all patient concerns and a lack of consensus for which PROM to use remains (37). Likewise, there is no consensus on which foot and ankle−specific PROMs to use among patients having undergone ankle fracture surgery (1,6,38,39). Nevertheless, the WOMAC has been widely used in the field of foot and ankle surgery (40−43), although it has not been previously validated for this purpose.…”

Section: Discussionmentioning

confidence: 99%

Validation of the Western Ontario and McMaster Universities Osteoarthritis Index in Patients Having Undergone Ankle Fracture Surgery

Ponkilainen

Häkkinen

Uimonen

et al. 2019

The Journal of Foot and Ankle Surgery

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The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) is a patient-reported outcome measure (PROM) that is widely used to evaluate the pain, stiffness, and physical function of patients with osteoarthritis of the hip and knee. Although the WOMAC has also been used for patients after foot and ankle surgery, it has not been validated for this purpose. A total of 130 patients with surgically treated ankle fractures completed the WOMAC, Visual Analogue Scale Foot and Ankle (VAS FA), Lower Extremity Functional Scale (LEFS), 15D Health-Related Quality-of-Life Questionnaire (15D), and Visual Analog Scale for General Health (VAS general health) after foot and ankle surgery. The structural validity of the WOMAC was assessed by using Cronbach's a, and convergent validity was tested between the WOMAC and reference outcome measures. Cronbach's a for the index score was 0.98 and 0.95, 0.86, and 0.98 for the Pain, Stiffness, and Physical Function subscales, respectively. The Spearman correlation coefficients were-0.84,-0.74,-0.58, and 0.55 for the VAS-FA, LEFS, 15D, and VAS general health, respectively. The relationships with the VAS-FA, LEFS, 15D, and VAS general health were strong. All relationships were statistically significant (p < .001). The WOMAC provides valid scores for assessing pain, stiffness, and physical function in patients having undergone ankle fracture surgery.

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AOFAS Position Statement Regarding Patient-Reported Outcome Measures

Cited by 68 publications

References 34 publications

Operative versus nonoperative treatment in children with painful rigid flatfoot and talocalcaneal coalition

Operative versus nonoperative treatment in children with painful rigid flatfoot and talocalcaneal coalition

Operative versus nonoperative treatment in children with painful rigid flatfoot and talocalcaneal coalition. Results from a retrospective comparative study.

Validation of the Western Ontario and McMaster Universities Osteoarthritis Index in Patients Having Undergone Ankle Fracture Surgery

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