Increased Activity Level Following Total Ankle Replacement Results in Improved Patient Reported Outcomes

While evidence highlights increased activity levels following total ankle replacement (TAR), the correlation between postoperative activity changes and ankle-surgery-specific patient-reported outcomes is unexplored. This retrospective cohort study investigates the effect of activity level changes on patient-reported outcomes, including the Manchester-Oxford Foot Questionnaire (MOXFQ) and patient satisfaction following TAR. Patient records from a single center performing TARs between January 2014 and February 2023 were reviewed alongside patient questionnaires completed preoperatively and at a mean follow-up of 44 ± 31 months postoperatively (range 6-134 months). Activity participation pre and postoperatively was assessed and correlated with MOXFQ scores. Data from 89 patients was available for analysis (mean age 72.3 ± 8.9 years [range, 48-92]). Postoperatively, 31 patients (35%) increased, 42 (47%) maintained, and 16 (18%) decreased their activity levels. The mean time to return to regular activity was 23.4 weeks. Preoperative MOXFQ scores were similar across all groups (increased: 74.03 ± 14.00; maintained: 73.6 ± 13.9; decreased: 77.0 ± 15.5; p = .71). All groups showed significant improvements in MOXFQ scores from preoperative to postoperative assessments (p < .05). Patients with increased activity levels showed greater MOXFQ improvements (-61.6 ± 19.0) compared to those with decreased activity levels (-38.3 ± 26.6) (p < .01). Following TAR, 82% of patients maintained or increased their activity levels. Patients with increased postoperative activity exhibited superior improvements in MOXFQ scores. These findings underscore the importance of promoting physical activity for optimal outcomes following TAR.