Outcome measures after foot and ankle surgery: A Systematic Review

Area of Science:

• Orthopedic Surgery
• Rehabilitation Medicine
• Clinical Measurement

Background:

• Limited research exists on outcome measures post-foot and ankle surgery.
• Methodological quality of existing studies is often not assessed.
• There is a need to evaluate patient-related outcome measures (PROMs) for foot and ankle surgery.

Purpose of the Study:

• To systematically review and evaluate the measurement properties of PROMs used in patients following foot and ankle surgery.
• To identify the most reliable and valid outcome measures for clinical practice and research.

Main Methods:

• A systematic review of Medline, Embase, and Web of Sciences databases was conducted from 2000 to April 2022.
• Studies involving foot and/or ankle surgery, described outcomes, and assessed measurement properties were included.
• Methodological quality was assessed using the Newcastle-Ottawa Scale (NOS) and COSMIN criteria.

Main Results:

• 143 studies (n=18,383) were reviewed, including 82 on PROMs and 61 on clinical outcomes.
• Twenty-three different PROMs were evaluated; the Foot and Ankle Outcome Score (FAOS) showed positive results for all measurement properties.
• The Lower Extremity Functional Scale (LEFS) and the Manchester-Oxford Foot Questionnaire (MOXFQ) also demonstrated positive results for most properties.

Conclusions:

• The FAOS is recommended as the most suitable PROM for monitoring foot and ankle outcomes and evaluating treatment effectiveness.
• Radiological measures, particularly plain radiographs and CT scans, showed high reliability for clinical outcomes.