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Arbab D, Lichte P, Gutteck N, Bouillon B, Arbab D. Reliability and validation of the German Achilles tendon Total Rupture Score. Knee Surg Sports Traumatol Arthrosc 2024; 32:454-460. [PMID: 38270292 DOI: 10.1002/ksa.12059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/21/2023] [Accepted: 01/03/2024] [Indexed: 01/26/2024]
Abstract
PURPOSE Patient-related outcome measures (PROMs) are important instruments to evaluate efficacy of orthopaedic procedures. The Achilles tendon Total Rupture Score (ATRS) is a PROM developed to evaluate outcomes after treatment of Achilles tendon ruptures (ATRs). Purpose of this study is to develop and culturally adapt the German version of the ATRS and to evaluate reliability and validity. METHODS The ATRS was translated by forward-backward translation based on common guidelines. In this retrospective study, 48 patients with a surgical intervention after ATR were recruited. Reliability was evaluated by intraclass correlation coefficient (ICC) and Cronbach's alpha. Construct validity was valued by determining Pearson correlation coefficient with the German version of the Foot and Ankle Outcome Score (FAOS) and the Victorian Institute of Sports Assessment-Achilles questionnaire (VISA-A). RESULTS The German Version of the ATRS has an excellent internal consistency (Cronbach's alpha 0.96) as well as an excellent test-retest-reliability (ICC 0.98). It has a moderately strong correlation with the VISA-A (r = 0.73) as well as with the FAOS subclasses (r = 0.6-0.79). CONCLUSION The German version of the ATRS demonstrated good psychometric properties. It proofed to be a valid and reliable instrument for use in patients with Achilles tendon Rupture. LEVEL OF EVIDENCE Level II.
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Affiliation(s)
- Dorothe Arbab
- Department of Orthopaedic and Trauma Surgery, Aachen University Hospital, Aachen, Germany
| | - Philip Lichte
- Department of Orthopaedic and Trauma Surgery, Aachen University Hospital, Aachen, Germany
| | - Natalia Gutteck
- Department of Orthopedic and Trauma Surgery, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Bertil Bouillon
- Department of Traumatology and Orthopedic Surgery, Cologne-Merheim Medical Center (CMMC), University of Witten/Herdecke, Cologne, Germany
| | - Dariusch Arbab
- Department of Orthopedic and Trauma Surgery, St. Elisabeth-Hospital Herten, Member Faculty of Health Witten/Herdecke University, Herten, Germany
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Gregersen MG, Robinson HS, Molund M. Concomitant Unstable and Stable Gravity Stress Tests on Weight-Bearing Stable Weber B Ankle Fractures Treated Nonoperatively: A 2-Year Outcome Study. J Bone Joint Surg Am 2023; 105:1435-1441. [PMID: 37498982 DOI: 10.2106/jbjs.23.00195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
BACKGROUND Replacing gravity stress tests with weight-bearing radiographs to evaluate the stability of Weber B (also called Lauge-Hansen supination-external rotation [SER]) ankle fractures results in a lower surgery rate, thus avoiding associated risks and complications. Still, nonoperative treatment of weight-bearing stable fractures is controversial because of the scarcity of strong evidence. We investigated the influence of a concomitant unstable gravity stress test compared with a stable gravity stress test on outcomes after nonoperative treatment of weight-bearing stable fractures. METHODS We performed a prospective, noninferiority study on 149 patients with Weber B ankle fractures and stable weight-bearing radiographs. Gravity stress radiographs classified fractures as stable (SER2 [n = 88]) or partially unstable (SER4a [n = 61]). All were treated with a functional orthosis and weight-bearing was allowed; patients were followed for 2 years. The primary outcome was the Manchester-Oxford Foot and Ankle Questionnaire (MOXFQ), with a range from 0 to 100, in which lower scores indicate fewer symptoms. A noninferiority margin was prospectively defined as 7.5 points. The secondary outcomes included the Olerud-Molander Ankle Score, assessment of ankle congruence, and treatment-related adverse events. RESULTS The primary outcome data were available for 144 (96.6%) of 149 participants at 2 years. The between-group difference in the MOXFQ score was 1.0 point (95% confidence interval, -1.4 to 3.4 points; p = 0.397) in favor of the SER2 group, consistent with noninferiority. We found no appreciable between-group differences for any other outcome. CONCLUSIONS In Weber B/SER ankle fractures that are stable on weight-bearing radiographs, are treated with removable orthoses, and are allowed to bear weight, a concomitant unstable gravity stress test (SER4a) was not associated with worse patient-reported or radiographic outcomes compared with a stable gravity stress test (SER2) at the 2-year follow-up. Thus, the identification of stress instability seems redundant, which questions the applicability of stress instability for surgical decision-making. LEVEL OF EVIDENCE Diagnostic Level II . See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Martin G Gregersen
- Department of Physical Medicine and Rehabilitation, Østfold Hospital Trust, Grålum, Norway
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | - Marius Molund
- Department of Orthopaedic Surgery, Østfold Hospital Trust, Grålum, Norway
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Gregersen MG, Justad-Berg RT, Gill NEQ, Saatvedt O, Aas LK, Molund M. Functional orthosis versus cast immobilization for weightbearing stable Weber B ankle fractures with concomitant unstable gravity stress tests. Bone Jt Open 2023; 4:713-719. [PMID: 37725035 PMCID: PMC10508240 DOI: 10.1302/2633-1462.49.bjo-2023-0012.r1] [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] [Indexed: 09/21/2023] Open
Abstract
Aims Treatment of Weber B ankle fractures that are stable on weightbearing radiographs but unstable on concomitant stress tests (classified SER4a) is controversial. Recent studies indicate that these fractures should be treated nonoperatively, but no studies have compared alternative nonoperative options. This study aims to evaluate patient-reported outcomes and the safety of fracture treatment using functional orthosis versus cast immobilization. Methods A total of 110 patients with Weber B/SER4a ankle fractures will be randomized (1:1 ratio) to receive six weeks of functional orthosis treatment or cast immobilization with a two-year follow-up. The primary outcome is patient-reported ankle function and symptoms measured by the Manchester-Oxford Foot and Ankle Questionnaire (MOxFQ); secondary outcomes include Olerud-Molander Ankle Score, radiological evaluation of ankle congruence in weightbearing and gravity stress tests, and rates of treatment-related adverse events. The Regional Committee for Medical and Health Research (approval number 277693) has granted ethical approval, and the study is funded by South-Eastern Norway Regional Health Authority (grant number 2023014). Discussion Randomized controlled trials are needed to evaluate alternative nonoperative treatment options for Weber B/SER4a ankle fractures, as current clinical guidelines are based on biomechanical reasoning. The findings will be shared through publication in peer-reviewed journals and presentations at conferences.
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Affiliation(s)
- Martin G. Gregersen
- Department of Physical Medicine and Rehabilitation, Østfold Hospital Trust, Grålum, Norway
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | - Nicolaj E. Q. Gill
- Department of Orthopaedic Surgery, Innlandet Hospital Trust, Gjøvik Hospital, Gjøvik, Norway
| | - Ola Saatvedt
- Department of Orthopaedic Surgery, Innlandet Hospital Trust, Gjøvik Hospital, Gjøvik, Norway
| | - Lars K. Aas
- Orthopaedic Department, Møre og Romsdal Hospital Trust, Ålesund Hospital, Alesund, Norway
| | - Marius Molund
- Department of Orthopaedic Surgery, Østfold Hospital Trust, Grålum, Norway
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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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Bello-Tejeda LL, Perez-Aznar A, Sebastia-Forcada E, Miralles-Muñoz FA, Lizaur-Utrilla A, Vizcaya-Moreno MF. Sesamoid Position Change Over 2 Years After Distal Chevron Osteotomy for Moderate to Severe Hallux Valgus: A Prospective Cohort Study. Foot Ankle Int 2023; 44:95-103. [PMID: 36692127 DOI: 10.1177/10711007221146192] [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] [Indexed: 01/25/2023]
Abstract
BACKGROUND Sesamoid position change after distal chevron osteotomy for moderate to severe hallux valgus is not well known in the literature. The objective of this study was to determine whether the sesamoid position changed over 2 years after distal chevron osteotomy for moderate to severe hallux valgus. METHODS Ninety-seven patients who underwent distal chevron osteotomy for moderate to severe hallux valgus were prospectively assessed for 2 years. There were 91 females, and the mean age was 54.9 (SD 10.9) years. The Self-Reported Foot and Ankle Score (SEFAS) was used for functional assessment. Foot pain was assessed by a 0-10 visual analog scale (VAS), and patient satisfaction by a 5-point Likert scale. Radiologically, hallux valgus angle (HVA), first-second intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA), metatarsal head displacement, and sesamoid position by the AOFAS criteria were analyzed. Patients were classified according to the medial sesamoid position on the first postoperative weightbearing radiograph (1º-WB-Xray) into the reduced sesamoid group (66 patients) and nonreduced sesamoid group (31 patients). RESULTS All patients were assessed preoperatively and postoperatively at 1 month and 2 years. On the 1º-WB-Xray, IMA was significantly lower in the reduced group (P = .038), but HVA (P = .063) and DMAA (P = .246) were not significantly different. At the final follow-up, no patients in the reduced group had sesamoid position change from 1º-WB-Xray, whereas 8 (25.8%) patients in the nonreduced group had change of their sesamoid positions. The SEFAS was not significantly different between groups preoperatively (P = .386) or at 1 month postoperation (P = .064). The final SEFAS, VAS pain, and satisfaction scores were significantly better in the reduced group, although the clinical significance of these changes remains unknown. CONCLUSION A nonreduced position of the sesamoids obtained in surgery can cause their increased malposition over 2 postoperative years and statistically less functional outcomes. LEVEL OF EVIDENCE Level II, prospective cohort study.
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Affiliation(s)
| | - Adolfo Perez-Aznar
- Department of Orthopaedic Surgery. Eldas University Hospital, Elda, Alicante, Spain
| | | | | | - Alejandro Lizaur-Utrilla
- Department of Traumatology and Orthopaedics. Faculty of Medicine, Miguel Hernandez University, Elche, Alicante, Spain
| | - M Flores Vizcaya-Moreno
- Unit of Research, Faculty of Health Sciences, University of Alicante, San Vicente Raspeig, Alicante, Spain
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Wheeler PC, Dudson C, Calver R. Radial Extracorporeal Shockwave Therapy (rESWT) is not superior to "minimal-dose" rESWT for patients with chronic plantar fasciopathy; a double-blinded randomised controlled trial. Foot Ankle Surg 2022; 28:1356-1365. [PMID: 35817643 DOI: 10.1016/j.fas.2022.06.016] [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: 03/11/2022] [Revised: 05/31/2022] [Accepted: 06/28/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Investigating outcomes following radial-extra-corporeal-shockwave-therapy (rESWT) in patients with chronic plantar fasciopathy METHODS: This double-blinded RCT in a single NHS Sports medicine clinic recruited 117 patients with chronic plantar fasciopathy randomised equally to either 3 sessions of rESWT or "minimal-dose" respectively. Mean age 51.7 ± 9.6 years, 66 % female, symptom duration: 32.6 ± 30.8 months. RESULTS "Average pain" improved by 50 % at 6-months, (>1/3 at interim time-points). Statistically significant within-group improvements were identified in pain, local function, and "ability" PROMs in both groups. Fewer benefits in activity levels or mood. No between-group differences were seen at the interim or final time-points. CONCLUSION 3 sessions of "recommended-dose" rESWT is non-superior to "minimal-dose" rESWT in patients with chronic plantar fasciopathy. rESWT may be ineffective in the treatment of patients with chronic plantar fasciopathy, "minimal-dose" rESWT may be sufficient for a therapeutic effect, or a greater number of treatment sessions may be required for benefit. LEVEL OF EVIDENCE Level I - Randomised controlled trial.
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Affiliation(s)
- Patrick C Wheeler
- Department of Sport & Exercise Medicine, University Hospitals of Leicester NHS Trust, UK; School of Sport, Exercise and Health Sciences, Loughborough University, UK; National Centre of Sport and Exercise Medicine, Loughborough, UK.
| | - Chloe Dudson
- Department of Sport & Exercise Medicine, University Hospitals of Leicester NHS Trust, UK
| | - Rachel Calver
- Department of Sport & Exercise Medicine, University Hospitals of Leicester NHS Trust, UK
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7
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Veracruz-Galvez E, Perez-Aznar A, Lizaur-Utrilla A, Lopez-Prats FA, Vizcaya-Moreno MF. Influence of sesamoid position after scarf osteotomy for hallux valgus on patient-reported outcome. A prospective cohor study. Foot Ankle Surg 2022; 28:471-475. [PMID: 34969596 DOI: 10.1016/j.fas.2021.12.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 12/08/2021] [Accepted: 12/19/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND The objective was to evaluate the influence of the postoperative sesamoid position as measured with conventional radiographs on the patient-reported outcome after scarf osteotomy. The hypothesis was that incomplete reduction of the sesamoid would result in a decreased functional outcome. METHODS Eighty-two patients who underwent scarf osteotomy for hallux valgus were prospectively assessed for up to two postoperative years. The Self-Reported Foot and Ankle Score (SEFAS) was used to assess the quality of life, and the American Orthopaedic Foot and Ankle Society Hallux Metatarsophalangeal-Interphalangeal Scale (AOFAS) for the functional outcome. A visual analogue scale (VAS) assessed pain, and Likert scale for patient satisfaction. Radiologically, hallux valgus angle (HVA), first-second intermetatarsal angle (IMA), and sesamoid position were analyzed. According to the final sesamoid position, patients were classified as normal position (48 patients) and outlier position (34 patients). A power analysis, conventional and logistic regression statistical analysis were performed. RESULTS At the final follow-up, significant improvements in all clinical scores were observed for both groups (p = 0.001) with no significant difference in AOFAS score (p = 0.413), but SEFAS score (p = 0.023), VAS-pain (p = 0.006), and satisfaction (p = 0.014) were significantly better in the normal group than in the outlier group. There were significant differences between groups in final HVA (p = 0.042) and IMA (p = 0.040). In multivariate analysis, only lower VAS-pain score (OR 0.4, 95% CI 0.2-0.6; p = 0.039) and normal sesamoid position (OR 2.4, 95% CI 1.6-3.2; p = 0.012) were significant predictor of patient satisfaction. CONCLUSION At two postoperative years, normal sesamoid position as measured on weight-bearing radiographs was associated with lower pain and better patient satisfaction in patients underwent scarf osteotomy for moderate to severe hallux valgus.
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Affiliation(s)
- Eva Veracruz-Galvez
- Department of Orthopaedic Surgery, Orihuela Hospital, Orihuela, Alicante, Spain
| | - Adolfo Perez-Aznar
- Department of Orthopaedic Surgery, Elda University Hospital Elda, Alicante, Spain
| | - Alejandro Lizaur-Utrilla
- Department of Traumatology and Orthopaedia, Faculty of Medicine, Miguel Hernandez University, Elche, Alicante, Spain.
| | - Fernando A Lopez-Prats
- Department of Traumatology and Orthopaedia, Faculty of Medicine, Miguel Hernandez University, Elche, Alicante, Spain
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Ayyaswamy B, Vaghela M, Alderton E, Majeed H, Limaye R. Early Outcome of a Single Peri-Tendinous Hyaluronic Acid Injection for Mid-Portion Non-Insertional Achilles Tendinopathy - A Pilot Study. Foot (Edinb) 2021; 49:101738. [PMID: 33132010 DOI: 10.1016/j.foot.2020.101738] [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: 07/07/2020] [Accepted: 08/29/2020] [Indexed: 02/04/2023]
Abstract
AIM The aim of this study was to evaluate the efficacy and safety of a single, peri-tendinous injection of hyaluronic acid for mid-portion, non-insertional Achilles tendinopathy. MATERIALS AND METHODS A prospective, open labelled, single center, pilot study was conducted. All patients enrolled received a single peri-tendinous injection of Ostenil Tendon™ (40 mg/2 ml 2% HA with 0.5% mannitol). Outcome measures were Visual Analogue Scale (VAS) pain score and Manchester-Oxford Foot Questionnaire (MOxFQ) scores at 2 weeks and at final follow at 12 weeks. Any major and minor adverse effects were recorded. To assess change in VAS and MOxFQ scores, t test and Wilcoxon signed rank test were employed. RESULTS Seventeen patients were enrolled in this study with a mean follow-up of 12 weeks. Mean pre-injection VAS score was 9.38 cm (9-9.8), which significantly reduced post-injection to a mean score of 4.09 cm (2-8) at week-2 stage, and further improved to 3.01 cm (2-3.9) at the final follow-up (p < 0.0001). MOxFQ score showed a significant improvement from pre-injection value of 67.77 (63.03-72.55) to 31.18 (13-60) at week-2 stage, and further improved to 24.20 (15.73-32.67) at the final follow-up (p < 0.0001). The mean improvement from pre-injection to the final follow up was 43.57 (34.25-52.90). No adverse effects for injections were recorded. CONCLUSION This small series suggests an encouraging response of a single injection of HA as an effective and safe option for non-insertional Achilles tendinopathy.
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Affiliation(s)
- Brijesh Ayyaswamy
- Department of orthopaedics, North Tees and Hartlepool NHS Trust, Hardwick road, Stockton on Tees, TS18 9PE, UK.
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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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Vieira Cardoso D, Dubois-Ferrière V, Hannouche D, Lübbeke A, Perneger T. Development and psychometric performance of the French language version of the Manchester-Oxford Foot Questionnaire (MOXFQ). Foot Ankle Surg 2020; 26:902-906. [PMID: 31882344 DOI: 10.1016/j.fas.2019.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 12/16/2019] [Accepted: 12/16/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND The Manchester-Oxford Foot Questionnaire (MOXFQ) is a 16-item patient-reported outcome measure (PROM) validated for use in patients with foot and ankle pathologies. It contains three sub-scores for pain, walking/standing and social interaction dimensions. The aim of this study was to develop a French language version of the MOXFQ and to assess its psychometric properties in patients affected by foot and ankle pathologies. METHODS According to guidelines, forward and backward independent translations were performed. The final French version was pre-tested in 45 patients. The French MOXFQ and the Short-form 36 Health Survey (SF-36) were filled in by 149 patients. A retest was performed in 39 patients. Internal consistency and test-retest reliability were assessed using Cronbach's alpha and intraclass correlation coefficient (ICC), respectively. Construct validity was assessed by factor analysis, and through correlations of MOXFQ scales with SF-36 scales. RESULTS Internal consistency coefficients were high with Cronbach's alpha ranging from 0.79 and 0.94. Test-retest ICCs were between 0.74 and 0.93. No floor or ceiling effects were observed. The correlations between French MOXFQ and French SF-36 subscales were moderate ranging from -0.33 to -0.71. CONCLUSIONS The French translation of the MOXFQ revealed good psychometric properties. Our French version proved to be a reliable instrument which can be used for evaluation of patients with foot and ankle disorders. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Diogo Vieira Cardoso
- Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals, Geneva, Switzerland.
| | - Victor Dubois-Ferrière
- Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals, Geneva, Switzerland
| | - Didier Hannouche
- Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals, Geneva, Switzerland
| | - Anne Lübbeke
- Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals, Geneva, Switzerland
| | - Thomas Perneger
- Division of Epidemiology, Geneva University Hospitals, Geneva, Switzerland
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11
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Yusuf F, Liu G, Wing K, Crump T, Penner M, Younger A, Veljkovic A, Sutherland JM. Validating the Foot and Ankle Outcome score for measuring foot dysfunction among hallux valgus surgery patients using item response theory. Foot Ankle Surg 2020; 26:864-870. [PMID: 31839477 DOI: 10.1016/j.fas.2019.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 09/16/2019] [Accepted: 11/08/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND There is an absence of high quality research validating instruments that measure foot and ankle related quality of life among hallux valgus (bunion) patients' perspectives. The Foot and Ankle Outcome Scale is a patient-reported outcome instrument, that when administered to patients with symptomatic hallux valgus, provides a patient-centric perspective of their foot function. The aim of this study is to assess the psychometric properties of the instrument's five subscales among preoperative bunion surgery patients. METHODS The Foot and Ankle Outcome Scale instrument measures Pain, Symptoms, Activities of Daily Living, Sport and Recreational Activities and Foot/Ankle Related Quality of Life. Preoperative data is collected from a sample of patients scheduled for surgical treatment of their condition in Vancouver, Canada. Classical and item response theory methods are used to report on reliability, validity and differential item functioning among subgroups. RESULTS This study included 249 surveys, representing an overall response rate of 44.1% among 564 eligible patients. The instrument demonstrated high reliability for all subscales, though 18 items across subscales, exhibited poor discrimination between item levels. Four items score differently according to patients' sex and one item scored differently by age. CONCLUSIONS The instrument measures five domains of health important to bunion patients. These findings suggest that the current instrument can be used with an understanding of its limitations, including redundant questions and sex-based differences. Future research should revise a number of items. The results highlight the importance of the psychometric analyses of instruments in specific patient populations.
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Affiliation(s)
- Fardowsa Yusuf
- School of Population and Public Health, University of British Columbia, Vancouver, Canada.
| | - Guiping Liu
- Centre for Health Services and Policy Research, School of Population and Public Health, University of British Columbia, Vancouver, Canada.
| | - Kevin Wing
- Department of Orthopaedics, University of British Columbia, 181 Keefer Place, Unit 221, Vancouver, Canada.
| | - Trafford Crump
- Department of Surgery, University of Calgary, Calgary, Alberta, Canada.
| | - Murray Penner
- Department of Orthopaedics, University of British Columbia, 181 Keefer Place, Unit 221, Vancouver, Canada.
| | - Alastair Younger
- Department of Orthopaedics, University of British Columbia, 181 Keefer Place, Unit 221, Vancouver, Canada.
| | - Andrea Veljkovic
- Department of Orthopaedics, University of British Columbia, 181 Keefer Place, Unit 221, Vancouver, Canada.
| | - Jason M Sutherland
- Centre for Health Services and Policy Research, School of Population and Public Health, University of British Columbia, Vancouver, Canada.
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12
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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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13
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Hernández-Castillejo LE, Martínez Vizcaíno V, Garrido-Miguel M, Cavero-Redondo I, Pozuelo-Carrascosa DP, Álvarez-Bueno C. Effectiveness of hallux valgus surgery on patient quality of life: a systematic review and meta-analysis. Acta Orthop 2020; 91:450-456. [PMID: 32408787 PMCID: PMC8023907 DOI: 10.1080/17453674.2020.1764193] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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 - The quality of life (QoL) of patients with hallux valgus (HV) usually improves postoperatively. Evidence regarding the effect of HV surgery on different domains of patient QoL remains inconclusive. This systematic review and meta-analysis estimates the effect of HV surgery on patient QoL through distinguishing effects on physical domains (comprising physical function and body pain domains) using the EuroQol-5D, short form (SF) health survey-12, and SF-36 QoL scales and a visual analogue scale (VAS) score and mental and social domains using QoL scales.Patients and methods - MEDLINE, EMBASE, Cochrane Library, and Web of Science databases were systematically searched from inception to March 2019 for studies on the effect of HV surgery on patient QoL. A standardized mean difference score was calculated for each specific QoL domain (mental, social, pain, physical, and VAS) using Cohen's d index. The pooled effect size (ES) was estimated using a random-effects model based on the DerSimonian and Laird method.Results - From 12 published studies selected, the estimated pooled ES for QoL was 1.01 (95% confidence interval [CI] 0.52-1.51; I2 = 87%) for body pain and 0.43 (CI 0.31-0.55, I2 = 35%) for physical function. Regarding the composite mental and social domains of QoL, the pooled ES estimates were 0.24 (CI 0.00-0.47, I2 = 80%) and 0.42 (CI 0.21-0.63, I2 = 6.4%), respectively. The pooled difference in means for the VAS score was -4.1 (CI -4.5 to -3.6, I2 = 90%).Interpretation - Our data showed that HV surgery decreased patients' perceptions regarding pain. Furthermore, the data confirmed that HV surgery increased patients' QoL, particularly concerning physical and social domains.
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Affiliation(s)
| | - Vicente Martínez Vizcaíno
- Health and Social Research Center, Universidad de Castilla La Mancha, Cuenca, Spain; ,Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile; ,Correspondence:
| | - Miriam Garrido-Miguel
- Health and Social Research Center, Universidad de Castilla La Mancha, Cuenca, Spain;
| | - Iván Cavero-Redondo
- Health and Social Research Center, Universidad de Castilla La Mancha, Cuenca, Spain; ,Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay
| | | | - Celia Álvarez-Bueno
- Health and Social Research Center, Universidad de Castilla La Mancha, Cuenca, Spain; ,Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay
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14
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Zhuang Z, Yang Y, Chhantyal K, Chen J, Yuan G, Ni Y, Liu D, Shi D. Central Tendon-Splitting Approach and Double Row Suturing for the Treatment of Insertional Achilles Tendinopathy. BIOMED RESEARCH INTERNATIONAL 2019; 2019:4920647. [PMID: 31531355 PMCID: PMC6720369 DOI: 10.1155/2019/4920647] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 07/13/2019] [Accepted: 07/28/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND To assess the clinical outcomes of central tendon-splitting approach and double row anchor suturing for the treatment of insertional Achilles tendinopathy. METHODS 28 patients (28 feet) diagnosed with insertional Achilles tendinopathy were included in this study. The inclusions were symptom of hindfoot pain around the insertion of the Achilles tendon, radiographic demonstration of calcification, or degeneration of the Achilles tendon, showing no symptom improvement even after standard nonsurgical treatment for more than six months. The X-ray revealed that patients had obvious posterior superior calcaneal exostosis with the possibility of friction with the Achilles tendon or intratendinous calcification. Surgical correction by the central tendon-splitting approach and double row Achilles tendon suturing was performed. The ankles were immobilized with plaster for four weeks postoperatively. The American Orthopaedic Foot and Ankle Society (AOFAS) score and visual analogue score (VAS) were assessed preoperatively and at 2 years postoperatively. At final follow-up, the Manchester-Oxford Foot Questionnaire (MOXFQ) as patient-reported outcome measures (PROMs) was also evaluated. RESULTS No complication, including postoperative wound infection and tendon rupture, was not found. All the patients resumed their daily activities with no high level of daily activities, such as jumping and jogging after 6 weeks postoperatively. 27 patients were available for follow-up for at least 2 years, while only one patient was lost to follow-up. At postoperative 2 years, the postoperative AOFAS score increased significantly, while the VAS score decreased statistically when compared with preoperative values. At final follow-up, 24 patients had complete alleviation of pain, whereas the remaining 3 patients complained of mild heel pain after walking for a long time. The MOXFQ score showed obvious relief of previous symptoms for all included cases. CONCLUSIONS Central tendon-splitting approach and double row Achilles tendon suture provide excellent intraoperative visual field, larger tendon-bone contact area, and stronger pullout strength and, thus, facilitate early rehabilitation. It can be a safe and effective method for the treatment of insertional Achilles tendinopathy.
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Affiliation(s)
- Ze Zhuang
- Departments of Joint Surgery and Orthopedic Trauma, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong, China
| | - Yang Yang
- Departments of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong, China
| | - Kishor Chhantyal
- Departments of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong, China
| | - Jianning Chen
- Departments of Pathology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong, China
| | - Guohui Yuan
- Departments of Joint Surgery and Orthopedic Trauma, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong, China
| | - Yirong Ni
- MOE Key Laboratory of Laser Life Science & SATCM Third Grade Laboratory of Chinese Medicine and Photonics Technology, College of Biophotonics, South China Normal University, Guangzhou 510631, China
| | - Dezhao Liu
- Departments of Anesthesiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong, China
| | - Dehai Shi
- Departments of Joint Surgery and Orthopedic Trauma, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong, China
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15
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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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