The need for a paradigm shift in the rehabilitation of elective foot and ankle reconstructive surgery patients? An annotation

Essop-Adam, Amirah; Houchen-Wolloff, Linzy; Vaishya, Raju; Mangwani, Jitendra

doi:10.1016/j.jcot.2020.04.001

Cited by 1 publication

(2 citation statements)

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“…There is evidence in the literature 9 that early rehabilitation could improve patient outcomes in this patient population, including reduced risk of VTE. 5 However the risk of wound problems and non-union are a theoretical concern.…”

Section: Discussionmentioning

confidence: 99%

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Post-operative rehabilitation in ankle and hindfoot/midfoot fusion and reconstruction surgery - A scoping survey of UK foot and ankle surgeons and allied health professionals

Houchen-Wolloff

Essop-Adam

Calver

et al. 2020

Journal of Clinical Orthopaedics and Trauma

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Objective: There has recently been a paradigm shift in the management of Achilles tendon rupture and ankle fracture rehabilitation with emphasis on early mobilisation. There is, however, no consensus on post-operative rehabilitation for hind/mid-foot fusion and reconstructive surgery. The aim was to scope the post-operative rehabilitation practices of UK foot and ankle surgeons and allied health professionals (AHPs). Methods: A 10 question online survey was sent to UK surgeons and AHPs via specialist interest groups in February 2019. Quantitative and qualitative data were analysed. Results: 117 surgeons and 55 AHPs responded. There was good agreement between survey responses in the 2 groups. Fifty percent reported that they followed a local post-operative rehabilitation protocol. More than half of respondents (57%) reported that not all patients were referred for post-operative rehabilitation. There was a wide variation in the time point at which patients were instructed to weight bear (2 weeks to >12-weeks). Non-union was a concern of early mobilisation as highlighted by 62% of respondents. Qualitative themes identified were: treatment tailored to individual patients, lack of knowledge about the patient journey, treatment tailored to surgeon preferences, lack of a pathway, variation in practice. Conclusions: There is a wide variation in the post-op rehabilitation of patients undergoing this surgery in the UK, with a lack of published research in this area. Early rehabilitation could improve patient outcomes, yet the risk of non-union is a major concern. Further research in the form of a multicentre trial is warranted to answer this research question.

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Section: Discussionmentioning

confidence: 99%

“…An online survey (10 questions) was designed (on surveymonkey: California, USA) following qualitative synthesis of published literature. 9 See box 1. Some questions were multiple choice, others had free text options and question 10 included both potential positive and negative consequences of early rehabilitation.…”

Section: Methodsmentioning

confidence: 99%