Patient reported outcome measures in the foot and ankle literature: A systematic review

Patient reported outcome measures (PROMs) are crucial in allowing clinicians to effectively evaluate the outcome of interventions. This systematic review aims to provide a comprehensive, up-to-date analysis of the use of PROMs in the foot and ankle literature.

A systematic review of all articles published between January 2012 and December 2022 in six major orthopaedic journals was performed. All original research articles reporting at least one PROM in any foot and ankle condition were included. An analysis of the most common PROMs overall and according to year of publication, journal of publication and pathology/procedure reported was performed.

Of the 4402 total foot and ankle articles identified, 1553 articles reporting 125 different PROMs were included. The most common PROM overall was the American Orthopaedic foot and Ankle Society (AOFAS) score, reported in 51.5 % of articles, followed by visual analogue scale (VAS) pain score (43.2 %), 36-item short form survey (SF-36) (13.5 %), Foot and Ankle Outcome score (FAOS) (10.8 %) and Foot and Ankle Ability Measure (FAAM) (7.6 %). Only 23 (1.5 %) studies reported the number of patients achieving the minimally clinically important difference.

Although AOFAS score use has declined over time, it remains widely cited despite its limitations and calls for alternatives. Various validated foot and ankle PROMs exist but are used inconsistently. The continued use of suboptimal PROMs limits the quality of conclusions in foot and ankle research. Therefore, greater consistency in using validated PROMs is essential for improving reliability in the literature.

Level IV, systematic review of level I-IV studies.