Return to Physical Activity Following Flatfoot Reconstruction

Abstract

Background: Progressive collapsing foot deformity (PCFD) is a debilitating condition encompassing several interrelated, progressive deformities requiring a combination of reconstructive procedures. Few studies investigate returns to activity following flatfoot reconstruction, and existing studies only examine 1 or 2 of the numerous procedures employed. This study aims to provide the first generalizable assessment of returns to sports and physical activity following reconstruction surgery in patients with flexible flatfoot deformity. Methods: Patients aged 18-60 years who underwent reconstructive surgery between February 16 and May 19 for symptomatic flexible-stage flatfoot deformity were identified by registry review. Eighty-two of 113 eligible patients (73%) were reached at a mean 2.9 years (range, 2.0-5.4) of follow-up with mean age at surgery of 48.9 years (range, 18-59). Returns to physical activity were evaluated with a sports-specific survey. Clinical outcomes were evaluated with Patient-Reported Outcomes Measurement Information System (PROMIS) scores. Results: Patients reported participation in 21 specific sports and activities. One-fourth (25.6%) of patients (21/82) reported increased difficulty with physical activities postoperatively, 15.9% reported equal difficulty, and 58.5% (48/82) reported decreased difficulty. Median return times were 9-12 months for participation and 12-18 months to reach maximum preoperative participation levels. Improvements in Physical Function ( P= .001), Pain Interference ( P < .001), Pain Intensity ( P <.001), and Global Physical Health ( P = .004) were associated with increased satisfaction with respect to sports and physical activities. Discussion: This study investigated participation in specific sports and physical activities following flatfoot reconstruction. Our findings suggest mixed outcomes, where many patients reported life-changing improvements but many also experienced prolonged pain and difficulty after surgery. Some patients reported increased difficulty or inability to return to their preoperative maximum level of participation, indicating that flatfoot reconstructions can lead to athletic limitations. Conclusion: Although flatfoot reconstruction can be a powerful tool to increase patients’ capacity to engage in physical activity, in our cohort many patients had reduced physical activity outcomes. Level of Evidence: Level IV, retrospective case series.

Prospective, Long-Term Functional Outcomes of Extra-Osseous Talotarsal Stabilization (EOTTS) Using HyProCure in Adult Patients with Talotarsal Joint Instability: Assessment of Physical Activity and Patient Satisfaction

“…Additionally, in our study, we observed that after surgery most patients were able to practice recreational sports at the level of 1-5 h/week (83%) and more than 5 h/week (15%). Fuller et al reported that the most frequently chosen activities among patients were walking, biking, and swimming and none of the activities were interrupted after the surgery [32]. Similar results were noted in our study and the main activities taken by patients were walking, cycling, swimming, and running.…”

“…In addition, the same study observed an increase in the amount of time spent on physical activity by about 19% after surgery [30]. Fuller et al showed in their study that 2.4% of patients were sedentary with no physical activity, 31.7% were moderately active, 29.3% were highly active, and 36.6% were extremely active after surgical treatment of flatfoot [32]. Additionally, in our study, we observed that after surgery most patients were able to practice recreational sports at the level of 1-5 h/week (83%) and more than 5 h/week (15%).…”

One double-loaded suture anchor is sufficient for all-inside arthroscopic anterior talofibular ligament repair

“…Although many factors (psychological factors, changes in priorities, and other problems) may determine return to activity after surgery, return to preinjury levels of sports activities or normal ankle functions is often considered as a major indicator for successful ankle surgeries [15, 18, 23]. Strong ligament reattachment would undoubtedly restore a stable ankle, and a stable ankle would allow CLAI patients to resume normal activities.…”