Influence of Diagnosis and Other Factors on Patients’ Expectations of Foot and Ankle Surgery

Cody, Elizabeth; Hương, Trần Thu; Koltsov, Jayme; Mancuso, Carol A.; Ellis, Scott J.

doi:10.1177/1071100718755473

Cited by 16 publications

(24 citation statements)

References 23 publications

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“…More than patients with other foot and ankle pathologies, patients with HV typically expect the ability to comfortably wear shoes and increase their shoe wear variety. 1 Studies on this topic generally agree that patients primarily expect pain relief but that they also have expectations related to shoe wear and foot appearance 3,10-12,14 Schneider and Knahr 11 interviewed 200 patients who underwent surgical management for HV and found that patients considered a decrease in pain and footwear problems to be the most important factors influencing outcomes. Saro et al 10 demonstrated that correction of the HV did not affect the SF-36 outcome score, but the ability of patients to choose footwear freely was a significant factor.…”

Section: Discussionmentioning

confidence: 99%

Effect of the Modified Lapidus Procedure for Hallux Valgus on Foot Width

Conti

MacMahon²,

Ellis

et al. 2019

Foot Ankle Int.

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Background: Despite the importance of shoe wear to patients with hallux valgus (HV), few studies have investigated changes in foot width following surgery in this population. The purpose of our study was to determine if the modified Lapidus procedure would effectively decrease foot width in patients with HV. Methods: Thirty-one feet (19 left, 12 right) in 30 patients (29 females, 1 male) who underwent a modified Lapidus procedure in combination with a modified McBride and Akin osteotomy for treatment of HV were included in the study. All patients had preoperative and at least 5-month postoperative imaging, consisting of both weightbearing radiographs and computed tomography (WBCT) scans, which were used to measure bony and soft tissue foot widths pre- and postoperatively by 2 independent observers. Results: Intraclass correlation coefficients (ICCs) demonstrated high interobserver reliability (all ICCs >0.90). Bony foot width decreased significantly, by a mean of 8.9 mm (9.1%) on radiographs and 7.9 mm (8.4%) on WBCT scans ( P < .001). The soft tissue foot width also decreased significantly, by a mean of 6.9 mm (6.3%) on radiographs and 6.7 mm (6.4%) on WBCT scans ( P < .001). Changes in the hallux valgus angle and intermetatarsal angle correlated with changes in bony foot width on WBCTs (both r > 0.4, P < .02). Conclusions: The modified Lapidus procedure in combination with a modified McBride and Akin osteotomy resulted in statistically significant changes in both bony and soft tissue foot width. Patients should be counseled that foot width decreases, on average, by 0.5 to 1 cm. Level of Evidence: Level III, comparative series.

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Section: Discussionmentioning

confidence: 99%

Effect of the Modified Lapidus Procedure for Hallux Valgus on Foot Width

Conti

MacMahon²,

Ellis

et al. 2019

Foot Ankle Int.

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“…21 Although these consensus statements, combined with the definition of treatment failure described above, are helpful in highlighting the indications for either a revision or salvage procedure, the optimal timing of a potential procedure will be variable based on a patient's overall health and psychological status, expectations, and perspective on additional surgery. 7 When developing treatment algorithms, clinicians should take these and the aforementioned factors into account.…”

Section: Resultsmentioning

confidence: 99%

Revision and Salvage Management: Proceedings of the International Consensus Meeting on Cartilage Repair of the Ankle

Ackermann

Adams²,

Andrews³

et al. 2018

Foot Ankle Int.

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“…This is supported by a previous study showing that they were among the most commonly cited preoperative expectations in foot and ankle patients. 3…”

Section: Discussionmentioning

confidence: 99%

“…This is supported by a previous study showing that they were among the most commonly cited preoperative expectations in foot and ankle patients. 3 About 60% of patients had higher expectations than their surgeons to improve the abilities to exercise for fitness and run for sports or exercise. Similarly, Ghomrawi et al found that 75.6% of THA and 80.0% of TKA patients had higher expectations than surgeons for improvement in the ability to exercise or participate in sports.…”

Section: Discussionmentioning

confidence: 99%

“…7,8,[12][13][14]18 Within foot and ankle surgery, diagnosis and other patient demographic and clinical factors have been found to be associated with higher patient expectations. 3,4 However, the extent to which surgeons' and patients' expectations align in foot and ankle surgery has seldom been evaluated. 17 Based on prior literature showing the role of patient expectations on influencing outcomes, it is important to understand differences between surgeon and patient expectations and factors that influence these differences in order for surgeons to appropriately educate patients about the realistic expectations of foot and ankle surgery.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Patients’ and Surgeons’ Expectations in Foot and Ankle Surgery

et al. 2020

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Background: Aligning patient and surgeon expectations may improve patient satisfaction and outcomes. This study aimed to assess differences in expectations of foot and ankle surgery between patients and their surgeons. Methods: Two hundred two patients scheduled to undergo foot or ankle surgery by one of 7 fellowship-trained foot and ankle surgeons were enrolled. Preoperatively, patients and surgeons completed the Hospital for Special Surgery Foot & Ankle Surgery Expectations Survey independently. Differences between patient and surgeon overall expectations scores, number of expectations, and number of expectations with complete improvement expected were assessed. A difference of ≥10 points was considered a clinically important difference in expectations score. Associations between patient demographic and clinical characteristics, major/minor surgery, and individual surgeon with differences in expectations were also assessed. Results: Overall, 66.3% of patients had higher expectations, 21.3% had concordant expectations, and 12.4% had lower expectations compared with their surgeons. On average, patients had higher expectations scores than their surgeons (70 ± 20 vs 52 ± 20 points, P < .001). Patients expected complete improvement in a greater number of expectations than surgeons (mean 11 ± 7 vs 1 ± 3, P < .001). Patients had higher expectations than surgeons for 18 of 23 items (78%). Items that had the greatest number of patients with higher expectations than surgeons were “improve confidence in foot/ankle,” “prevent foot/ankle from getting worse,” and “improve pain at rest.” Higher body mass index (BMI) ( P = .027) and individual surgeon ( P < .001) were associated with greater differences between patient-surgeon expectations. Major/minor surgery was not associated with differences in expectations ( P ≥ .142). Conclusion: More than two-thirds of patients had significantly higher expectations than their surgeons. Higher BMI was associated with higher patient than surgeon expectations. These results emphasize the importance for foot and ankle surgeons to adequately educate patients preoperatively. Level of Evidence: Level II, prospective comparative study.

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Influence of Diagnosis and Other Factors on Patients’ Expectations of Foot and Ankle Surgery

Abstract: Level II, cross-sectional study.

Cited by 16 publications

References 23 publications

Effect of the Modified Lapidus Procedure for Hallux Valgus on Foot Width

Effect of the Modified Lapidus Procedure for Hallux Valgus on Foot Width

Revision and Salvage Management: Proceedings of the International Consensus Meeting on Cartilage Repair of the Ankle

Comparison of Patients’ and Surgeons’ Expectations in Foot and Ankle Surgery

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