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Factors Associated With Poor Patient-Reported Outcomes in Isolated Gastrocnemius Recession for Heel Pain
Thomas Sanchez1, Turner Sankey1, Connor Donley1
1Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.
Foot & Ankle Orthopaedics
|April 28, 2023
Summary
Gastrocnemius recession outcomes are impacted by patient factors like tobacco use, prior surgeries, and BMI. Identifying these risk factors is crucial for improving patient-reported results in foot and ankle procedures.
Area of Science:
- Orthopedic Surgery
- Foot and Ankle Surgery
- Patient-Reported Outcomes
Background:
- Gastrocnemius recession is a common procedure for foot and ankle pathologies.
- Limited studies characterize risk factors affecting patient-reported outcomes (PROs) after this surgery.
- Understanding these factors is essential for optimizing surgical results and patient satisfaction.
Purpose of the Study:
- To identify risk factors associated with poor patient-reported outcomes following isolated gastrocnemius recession.
- Specifically focusing on patients with plantar fasciitis or insertional Achilles tendinopathy.
- To compare patient outcomes with the general population using PROMIS scores.
Main Methods:
- A retrospective cohort study of 189 patients undergoing gastrocnemius recession (Strayer or Baumann procedure).
- Data collected included demographics, comorbidities, Visual Analog Scale (VAS) pain scores.
- Postoperative outcomes assessed via telephone interviews using Patient-Reported Outcomes Measurement Information System (PROMIS) and Foot Function Index (FFI) scores.
Main Results:
- Tobacco use significantly decreased PROMIS physical function, pain interference, and FFI scores.
- Prior foot and ankle surgery was associated with decreased PROMIS pain interference, higher PROMIS depression, and lower FFI pain scores.
- Hypertension, BMI > 30, and peripheral neuropathy were linked to higher FFI disability and activity limitation scores.
- Significant improvement in VAS pain scores was observed from pre- to postoperative periods (5.53 to 2.11).
Conclusions:
- Several patient factors, including tobacco use, previous foot/ankle surgeries, and BMI, independently impact PROs after gastrocnemius recession.
- These findings highlight the importance of considering individual patient characteristics for optimizing outcomes.
- The study reinforces the efficacy of gastrocnemius recession while identifying key variables influencing patient-reported results.
