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Do foot & ankle assessments assist the explanation of 1 year knee arthroplasty outcomes?

Do foot & ankle assessments assist the explanation of 1 year knee arthroplasty outcomes?
Do foot & ankle assessments assist the explanation of 1 year knee arthroplasty outcomes?
Objective
Whilst a number of risk factors for poor patient reported outcome measures (PROMs) following knee arthroplasty (KA) have been identified, unexplained variability still remains. The role of pre-operative foot and ankle status on such outcomes has not been investigated. The aim of this study was therefore to determine the association of clinical foot and ankle assessments with patient reported outcomes 1 year following KA.

Design
One hundred and fifteen participants from the Clinical Outcomes in Arthroplasty Study (COASt), underwent detailed foot and ankle assessments at baseline, prior to KA (2012–2014) and were followed up for self-reported outcomes 1 year after surgery.

Results
Thirty nine percent of subjects reported foot pain at baseline. Mean pre-operative Oxford Knee Score (OKS; 0 [worst] to 48 [best outcome]) was 21 and post-operative OKS score was 38. In fully adjusted analysis pre-operative foot pain was significantly associated with 1 year outcome (risk ratio [RR] 0.78 95% confidence interval [95% CI] 0.62, 0.98). No significant association was observed between ankle dorsiflexion or foot posture and outcome.

Conclusions
Patients with pre-operative foot pain are more likely to have poorer clinically important outcomes 1 year following KA than patients without foot pain. Static ankle dorsiflexion and foot posture do not further explain post-operative KA outcomes. Consideration should also be given to address pre-operative foot pain when attempting to achieve a good clinical outcome for KA.
1063-4584
892-898
Gates, Lucy
bc67b8b8-110b-4358-8e1b-6f1d345bd503
Bowen, Catherine
fd85c3c5-96d9-49b8-86c6-caa94e1a222b
Sanchez-Santos, M.T.
4624bb05-b067-472b-b128-927b1ff8df7a
Delmestri, A.
c1dfbd4f-1ec0-4e02-a6fa-423f90edc322
Arden, Nigel
23af958d-835c-4d79-be54-4bbe4c68077f
Gates, Lucy
bc67b8b8-110b-4358-8e1b-6f1d345bd503
Bowen, Catherine
fd85c3c5-96d9-49b8-86c6-caa94e1a222b
Sanchez-Santos, M.T.
4624bb05-b067-472b-b128-927b1ff8df7a
Delmestri, A.
c1dfbd4f-1ec0-4e02-a6fa-423f90edc322
Arden, Nigel
23af958d-835c-4d79-be54-4bbe4c68077f

Gates, Lucy, Bowen, Catherine, Sanchez-Santos, M.T., Delmestri, A. and Arden, Nigel (2017) Do foot & ankle assessments assist the explanation of 1 year knee arthroplasty outcomes? Osteoarthritis and Cartilage, 25 (6), 892-898. (doi:10.1016/j.joca.2016.12.022).

Record type: Article

Abstract

Objective
Whilst a number of risk factors for poor patient reported outcome measures (PROMs) following knee arthroplasty (KA) have been identified, unexplained variability still remains. The role of pre-operative foot and ankle status on such outcomes has not been investigated. The aim of this study was therefore to determine the association of clinical foot and ankle assessments with patient reported outcomes 1 year following KA.

Design
One hundred and fifteen participants from the Clinical Outcomes in Arthroplasty Study (COASt), underwent detailed foot and ankle assessments at baseline, prior to KA (2012–2014) and were followed up for self-reported outcomes 1 year after surgery.

Results
Thirty nine percent of subjects reported foot pain at baseline. Mean pre-operative Oxford Knee Score (OKS; 0 [worst] to 48 [best outcome]) was 21 and post-operative OKS score was 38. In fully adjusted analysis pre-operative foot pain was significantly associated with 1 year outcome (risk ratio [RR] 0.78 95% confidence interval [95% CI] 0.62, 0.98). No significant association was observed between ankle dorsiflexion or foot posture and outcome.

Conclusions
Patients with pre-operative foot pain are more likely to have poorer clinically important outcomes 1 year following KA than patients without foot pain. Static ankle dorsiflexion and foot posture do not further explain post-operative KA outcomes. Consideration should also be given to address pre-operative foot pain when attempting to achieve a good clinical outcome for KA.

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Do foot & ankle assessments assist the explanation of one year knee.pdf - Accepted Manuscript
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More information

Accepted/In Press date: 22 December 2016
e-pub ahead of print date: 30 December 2016
Published date: June 2017
Organisations: Faculty of Health Sciences

Identifiers

Local EPrints ID: 404465
URI: http://eprints.soton.ac.uk/id/eprint/404465
ISSN: 1063-4584
PURE UUID: ba1beb17-6b3e-4716-916f-0202d24387ca
ORCID for Lucy Gates: ORCID iD orcid.org/0000-0002-8627-3418
ORCID for Catherine Bowen: ORCID iD orcid.org/0000-0002-7252-9515

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Date deposited: 10 Jan 2017 14:18
Last modified: 16 Mar 2024 04:05

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Contributors

Author: Lucy Gates ORCID iD
Author: Catherine Bowen ORCID iD
Author: M.T. Sanchez-Santos
Author: A. Delmestri
Author: Nigel Arden

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