Short-term and mid-term outcome of total ankle replacement in haemophilic patients

BackgroundAnkle arthropathy is very frequent in haemophilic patients. Prostheses are valuable alternatives to arthrodesis in non-haemophilic patients. We report the experience of a single centre in France on the use of prostheses in haemophilic patients.MethodsRetrospective study of 21 patients with haemarthropathy who underwent ankle arthroplasty (32 ankles), with additional surgery, if needed, from July 2002 to September 2009 (mean follow-up 4.4 ± 1.7 years). The American Orthopaedic Foot and Ankle Society (AOFAS) ankle–hindfoot scale was used to evaluate pain, function, ankle mobility and alignment.ResultsThe overall AOFAS score improved from 40.2 ± 19.4 (pre-surgery) to 85.3 ± 11.4 (post-surgery). The function score increased from 23.6 ± 7.7 to 35.9 ± 6.7 and dorsiflexion from 0.3° ± 5.0° to 10.3° ± 4.4°. Two patients underwent further ankle arthrodesis. On X-ray, both tibial and talar components were stable and correctly placed in all ankles. Alignment was good.ConclusionAnkle arthroplasty is a promising alternative to arthrodesis in haemophilic patients.     

Reconstruction of a missing or insufficient distal fibula in the setting of a total ankle replacement: The Milanese technique

BackgroundThe presence of an intact distal fibula is reported as a prerequisite when considering total ankle replacement and its lack is usually considered a contraindication. The purpose of the study was to describe the results of a surgical technique to reconstruct the distal fibula (Milanese fibular reconstruction technique) in the setting of a total ankle replacement and insufficient fibula.MethodsRetrospective analysis of 15 patients (15 ankles) who underwent rotational fibular reconstruction technique with minimum follow-up of 24 months. Patients were evaluated preoperatively and at the last follow-up with AOFAS Ankle and Hindfoot score, VAS pain scale, SF-12 and range of motion. Standard weightbearing radiographs were used for radiographic assessment.ResultsThe average of all clinical scores significantly improved (P < .001). The average radiographic parameters showed a neutral alignment. No cases of reabsorption of the new lateral malleolus were observed even in cases with complications that accounted for 2 superficial wound infection and 2 deep infections.ConclusionsThe Milanese fibular reconstruction technique can successfully reestablish a lateral strut and in the setting of an ankle prosthesis in patients with an insufficient fibula.     

Combined subtalar distraction arthrodesis with peroneus brevis tenotomy for posttraumatic subtalar arthritis

BackgroundSubtalar distraction arthrodesis is advocated as a salvage procedure for isolated posttraumatic subtalar arthritis. This study aimed at evaluating combined subtalar distraction arthrodesis with peroneus brevis tenotomy for such cases.MethodsTwenty patients with isolated posttraumatic subtalar arthritis managed by combined subtalar distraction arthrodesis and peroneus brevis tenotomy were reviewed for a retrospective study. The American orthopaedic foot and ankle society [AOFAS] hindfoot scoring, talocalcaneal height [TCH], talocalcaneal angle [TCA] and heel valgus angle [HVA] were used for both pre and postoperative assessments.ResultsThe mean postoperative [TCH] [70.3 ± 1.9 mm] was statistically better than the preoperative value [64.7 ± 2.2 mm] [p < 0.001]. There was a statistically significant decrease in [HVA] [p < 0.001]. On the contrary, there was a statistically significant increase in both [AOFAS] hindfoot scoring and the [TCA] [p < 0.001].ConclusionsApplying this technique for isolated posttraumatic subtalar arthritis with peroneal tendinitis improved both lateral retromalleolar swelling and deformity correction.     

Clinical outcomes comparing arthroscopic vs open ankle arthrodesis

BackgroundOver the last twenty years, minimally invasive ankle arthrodesis has evolved into a well-tolerated and safe procedure. It has grown in favor to open ankle arthrodesis due to shorter length of stay and fewer complications recorded. This paper aims to compare the clinical outcomes of arthroscopic vs open ankle arthrodesis at 24-months followup.MethodsFrom 2004 to 2015, we reviewed a prospectively collected database in a tertiary hospital foot and ankle registry. 28 feet that underwent arthroscopic ankle arthrodesis were matched to 56 feet that underwent open ankle arthrodesis for age, sex and body mass index (BMI). Visual analogue scale (VAS) scores, American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-hindfoot Scores and Short Form Health Survey (SF-36) were obtained to assess clinical outcomes. These parameters were collected before surgery, at 6 months and 24 months after surgery.ResultsThe arthroscopic group demonstrated significant less pain in the perioperative period (arthroscopic: 1.9 ± 1.2, open: 3.8 ± 1.1, p < 0.001) and shorter length of hospitalization stay (arthroscopic: 2.1 ± 0.7 open: 3.5 ± 1.7, p < 0.001). Patients who underwent arthroscopic ankle arthrodesis also reported a higher SF-36 score on physical functioning at 6 months (arthroscopic: 58.4 ± 27.1, open: 47.1 ± 24.0, p < 0.05) and higher AOFAS Ankle-hindfoot Scale score at 24-months (arthroscopic: 78.9 ± 18.9, open: 68.9 ± 24.7, p < 0.05). There were no postoperative complications in the arthroscopic group but 11 in the open group, including 9 which required followup operations. There was no significant difference in length of operative procedure between both groups.ConclusionsWe conclude that the arthroscopic group displayed better clinical outcomes compared to the open group at the 24 months followup. The advantages of arthroscopic ankle arthrodesis include significantly less perioperative pain, higher AOFAS Ankle-hindfoot scores at 24 months, shorter length of stay, fewer postoperative complications and followup operations.Level of evidenceLevel III, retrospective comparative series.     

Total ankle replacement in patients with end-stage ankle osteoarthritis: Clinical results and kinetic gait analysis

BackgroundTotal ankle arthroplasty is being used more frequently as an alternative for arthrodesis in final stages of ankle osteoarthritis. However, there are few studies which describe the biomechanics of gait of these patients.MethodsBetween March 2006 and May 2011, 17 patients (n = 18 ankles) suffering end-stage osteoarthritis of the ankle who underwent an ankle replacement (HINTEGRA) were evaluated retrospectively. We evaluated clinical, radiological and biomechanical gait parameters using the NedAMH/IBV dynamometric platform.ResultsAt last follow-up (average: 37 months), the AOFAS score improved from 31 to 83 with a high rate of satisfaction (83.3%). Kinetic gait parameters were more similar to a healthy ankle. We detected a radiolucent line in 8 patients (44%) without any subsidence case.ConclusionsOur study showed a high rate of satisfaction and biomechanics of the gait similar to a healthy ankle. The complication rate was analogous to those previously published in the literature.     

Computer-assisted surgery (CAS) based correction of posttraumatic ankle and hindfoot deformities—Preliminary results

The first clinical experiences with a computer assisted surgery based (CAS) guided correction arthrodeses at ankle, hindfoot and midfoot were evaluated.MethodsTime spent, accuracy, surgeons’ rating (Visual Analogue Scale [VAS], 0–10 points) were analyzed. The accuracy was assessed by ISO-C 3D (Siremobile™, Siemens, Germany).Results10 patients were included (ankle, n = 3; subtalar joint, n = 6; ankle and subtalar joint, n = 2; Lisfranc joint, n = 1). Time needed for preparation was 500 s (400–900). The correction process took 45 s (30–60). All angles/translations were achieved as planned before surgery (≤ ±1°/±1 mm). The ratings of the three involved surgeons were: feasibility, 9.5 (9–10); accuracy 9.8 (9.5–10); clinical benefit 9 (8–10).ConclusionsCAS guided correction of posttraumatic deformities of the ankle and hindfoot region provides very high accuracy and a fast correction process. The significance of the introduced method may be high in those cases, because the improved accuracy may lead to an improved clinical outcome.     

关节镜监视下踝关节植骨融合术的疗效分析

目的：探讨关节镜辅助下踝关节清理、植骨融合术的手术方法和临床疗效。方法：2001年1月至2009年5月,采用关节镜辅助踝关节植骨融合术治疗踝关节病变25例,男18例,女7例;年龄32～70岁,平均47.5岁;左踝10例,右踝15例;其中创伤后骨关节炎13例,地方性大骨节病10例,类风湿性关节炎2例。手术前后采用疼痛视觉模拟评分（VAS）对踝关节疼痛进行评定,根据美国足踝关节协会评分系统（AOFAS）从疼痛、自主活动、最大步行距离、地面步行、步态、活动度、稳定性及踝关节对线等方面进行评价。结果：25例均获随访,时间20～35个月,平均27.5个月。术后踝关节无疼痛,步态明显改善,无神经血管损伤、感染和固定失败等并发症,平均骨性融合时间为11.7周（8～15周）。术后VAS评分为（1.20±0.82）分,较术前的（8.60±0.96）分明显降低（t=27.326,P=0.000）;术后AOFAS评分中客观项目均较术前改善,术后AOFAS评分为（82.44±4.96）分,较术前的（36.44±9.90）分明显增加（t=-19.178,P=0.000）。结论：关节镜监视下踝关节植骨融合术操作简单,术中创伤小,术后恢复快、并发症少,是踝关节融合的理想方法。     

High incidence of osteochondral lesions after open reduction and internal fixation of displaced ankle fractures: Medium-term follow-up of 100 cases

BackgroundThe incidence of osteochondral lesions (OCLs) in association with displaced ankle fractures has only been examined in two previous studies. In both studies magnetic resonance imaging (MRI) was performed prior to open reduction and internal fixation (ORIF). Because MRI may overdiagnose or overestimate the extent of OCLs in an acute trauma setting the aim of this study was to determine the incidence of OCLs after ORIF of displaced ankle fractures using MRI at medium-term follow-up, and to analyse if the severity of fracture or the clinical outcome correlates with the incidence of OCLs.Patients and methodsFollowing institutional review board approval a total of 100 patients (mean age, 41.3 years; range, 17.9–64.3 years) with a displaced ankle fracture who had undergone ORIF according to the AO principles were included in this study. The American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score was used to quantify the clinical outcome and MR images were evaluated for OCLs of the talus and distal tibia after a mean of 34.5 months (range, 17.5–54.1 months).ResultsOCLs were found in 40.4% of the patients. Logistic regression revealed a significant correlation between the severity of fracture and the incidence of OCLs. Patients with a trimalleolar fracture (p = 0.04) or an ankle fracture dislocation (p = 0.003) had a significantly higher risk for developing an OCL compared to those with a type B fracture. Logistic regression also demonstrated a significant correlation between the clinical outcome (AOFAS score) and the incidence of OCLs (p = 0.01). The risk for developing an OCL increases up to 5.6% when the AOFAS score decreases by one point.ConclusionOCLs were frequently found in association with acute ankle fractures at medium-term follow-up, and the severity of fracture was associated with an increased number of OCLs. Considering the disadvantages of MRI including the high cost and limited availability, the results of this study may help to explain why anatomic surgical realignment of displaced ankle fractures may still be associated with poor clinical outcomes.     

踝关节融合治疗创伤后踝关节炎

 目的 探讨踝关节融合治疗创伤后踝关节炎的早期临床疗效。方法 回顾性分析2008年1月至2012年5月,采用踝关节融合治疗并获得随访的47例创伤后踝关节炎患者资料,男28例,女19例;年龄14～72岁,平均44岁;均为Morrey-Wiedeman 3期踝关节炎,其中17例合并距下关节炎;31例有明显足内外翻畸形或马蹄足畸形,16例外观大致正常。采用Kofoed踝关节评分、美国足踝外科协会(American Orthopaedic Foot and Ankle Society, AOFAS)踝与后足评分、Maryland足部评分及视觉模拟评价(visual analogue scale, VAS)评价术前及末次随访时足踝关节功能。结果 47例患者均获得随访,随访时间为5～52个月,平均25个月。末次随访时踝关节均融合,其中1例术后出现感染,经去除内固定及清创后踝关节融合。43例主观满意度为非常满意或满意,4例为一般,满意率为91.5%(43/47)。Kofoed评分,末次随访时平均为(80.96±6.07)分,与术前(48.11±5.00)分比较,差异有统计学意义;AOFAS评分,末次随访时平均为(82.21±4.26)分,与术前(53.38±5.52)分比较,差异有统计学意义;Maryland评分,末次随访时平均为(88.94±5.14)分,与术前(49.74±5.71)分比较,差异有统计学意义;VAS评分,末次随访时平均为(2.28±1.10)分,与术前(7.89±0.87)分比较,差异有统计学意义。踝关节正位X线片中,22例踝融合于中立位,19例外翻< 5°,3例外翻5°～10°,2例内翻< 5°,1例内翻5°～10°;侧位X线片中,32例踝融合于背伸中立位,12例跖屈5°以内,3例跖屈5°～10°。结论 踝关节融合治疗严重的创伤后踝关节炎早期即可纠正畸形、缓解疼痛与重建功能,是治疗创伤后踝关节炎的良好选择。     

Perioperative axial loading computed tomography findings in varus ankle osteoarthritis: Effect of supramalleolar osteotomy on abnormal internal rotation of the talus

BackgroundWe used axial loading computed tomography (AL CT) to evaluate preoperative and postoperative talocrural joints of patients who underwent supramalleolar osteotomy (SMO) to treat varus ankle osteoarthritis.MethodsWe performed retrospective analyses of 16 patients (18 feet) who underwent SMO including fibular osteotomy. Radiographic assessment was performed with weightbearing radiographs and AL CT. Clinical outcomes were assessed based on American Orthopedic Foot & Ankle Society (AOFAS) scale, visual analog scale (VAS) for pain, and Foot and Ankle Ability Measure (FAAM).ResultsThe mean 2-year follow-up tibial-ankle surface angle, talar tilt angle, Takakura stage, and tibial-lateral surface angle were all significantly different relative to preoperative parameters (P < .05). The mean 6-month follow-up talus rotation ratio was significantly corrected compared to the preoperative value (P = .001). The mean 2-year follow-up AOFAS, VAS at gait, and FAAM scores were all significantly improved relative to preoperative measurements (P = .001).ConclusionsAbnormal internal rotation of the talus in mild to moderate varus ankle osteoarthritis found on AL CT was significantly corrected after SMO.Level of evidenceTherapeutic Level IV     

Reconstruction of the lateral ankle ligaments using the anterior half of peroneus longus tendon graft

Background

This study aimed to report our institution’s experience in the treatment of chronic lateral ankle instability using the anterior half of the peroneus longus tendon (AHPLT) to reconstruct the lateral ligament.

Transfibular ankle arthrodesis with use of sagitally split fibula as a biological plate leads to excellent outcome: A retrospective analysis

BackgroundWe studied ankle arthrodesis with a transfibular approach using sagitally spilitted fibula as a biological plate (onlay grafting) as well as other half of fibula as morcellised local interpositional graft (inlay grafting) to achieve bony union.Material and methodsRetrospective clinico-radiological evaluation of 36 operated cases was done at 3, 6, 12 and 30 months follow-ups. Clinically union was considered once ankle became pain free on full weight bearing. Pain assessment was done by using VAS (visual analogue scale) score and functional evaluation was done by AOFAS (American Orthopaedic Foot & Ankle Society) hind foot score preoperatively and at different follow ups. Radiologically, sagittal plane ankle alignment and fusion status was determined at each follow up.ResultsMean age of patients was 40.36 ± 10.56 years (range 18–55), who were evaluated for mean duration of 33.32 ± 11.25 months (range 24–65). Thirty-three (91.7%) ankles were fused adequately and mean duration to achieve bony union was 5.09 ± 1.3 months (range 4–9 months). Mean post-operative AOFAS score at final follow up was 76.65 ± 4.87 in comparison to 45.76 ± 3.38, preoperatively. VAS score improved significantly from 7.8 (pre-operative) to 2.3 (final follow-up). Non-union in three patients (8.3%) and ankle malalignment in one patient was observed.ConclusionTransfibular ankle arthrodesis achieves excellent bony unions and functional outcomes in severe ankle arthritis. Biologically incompetent fibula that to be judged individually by the operating surgeon to use it as a graft. Patients having inflammatory arthritis have more dissatisfaction than other aetiologies.     

Biphasic bioresorbable scaffold (TruFit Plug®) for the treatment of osteochondral lesions of talus: 6- to 8-year follow-up

BackgroundThe ideal treatment of osteochondral lesions of the talus (OLT) is debatable. The TruFit plug has been investigated as a potential treatment method for osteochondral defects. This is a biphasic scaffold designed to stimulate cartilage and subchondral bone formation. The purpose of this retrospective study was to investigate the long-term functional and MRI outcomes of the TruFit Plug for the treatment of OLT.MethodsTwelve consecutive patients treated from March 2007 to April 2009 for OLT were evaluated. Clinical examination included the American Orthopaedic Foot and Ankle Society (AOFAS) ankle score and the visual analog scale (VAS) for pain. MRI scans were optained pre-treatment and at last follow-up. The Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score was used to assess cartilage incorporation.ResultsMean follow-up was 7.5 years (range, 6.5–8.7 years). The average age was of 38.6 years (range, 22–57 years). The sex ratio between males and females was 3:1 (9 males, 3 females). The mean AOFAS score improved from a preoperative score of 47.2 ± 10.7 to 84.4 ± 8 (p < 0.05). According to the postoperative AOFAS scores 1 case obtained excellent results, 9 were classified as good, and 2 were fair. VAS score improved from a preoperative value of 6.9 ± 1.4 points to 1.2 ± 1.1 points at last follow-up (p < 0.05). The MOCART score for cartilage repair tissue on postoperative MRI averaged 61.1 points (range, 25–85 points).ConclusionsThe long-term results suggest that the technique of Trufit Plug for OLT is safe and demonstrates good post-operative scores including improvement of pain and function, with discordant MRI results. However, randomized controlled clinical trials comparing TruFit Plug with an established treatment method are needed to improve synthetic biphasic implants as therapy for osteochondral lesions.Level of evidence: Retrospective case series, Level IV.     

关节镜清理术治疗急性痛风性踝关节炎疗效的临床观察

目的 :评估关节镜治疗急性痛风性关节炎的疗效。方法 :2010年1月至2012年6月关节镜辅助下治疗急性痛风性踝关节炎41例,全部为男性,平均年龄43岁(28~69岁);左踝18例,右踝23例;首次发作12例,反复发作29例;病程2周~30个月。结果:所有患者获得随访,随访至少12个月。采用美国足踝外科协会(AOFAS)踝-后足评分系统,术前58.44±9.45,术后6、12个月和末次随访时分别为86.15±7.36,83.41±9.22,84.10±8.22,术后评分升高。术后踝关节肿胀、疼痛显著改善。结论:关节镜检查有助于痛风性踝关节炎的诊断、改善临床症状和踝关节功能。     

Bipolar fresh total osteochondral allograft in the ankle: Is it a successful long-term solution?

IntroductionSevere post-traumatic ankle arthritis poses a reconstructive challenge in young and active patients. Although technically demanding and despite unsolved immunological issues, bipolar fresh total osteochondral allograft (BFTOA) represent an intriguing option to arthrodesis and prosthetic replacement. The purpose of this paper is to evaluate the outcomes of a series of 48 ankle BFTOA at 10 years follow up and to investigate the rate of survival long term.Methods58 patients underwent BFTOA, of these 48 were available for follow up. The allograft was prepared with the help of specifically designed jigs and the surgery was performed using either a lateral or a direct anterior approach. Patients were evaluated clinically and radiographically preoperatively, and at a mean 121 ± 18 months of follow-up.ResultsThe AOFAS score improved from 31 ± 11 pre operatively, to 65 ± 25 at the last (p < 0.0005). Fourteen failures occurred, with 70.8% allograft rate of survival. All the surviving allografts showed a reduction of the ankle joint movement, still associated with a satisfactory clinical result.ConclusionThe use of BFTOA represents an intriguing option to arthrodesis or arthroplasty. A satisfactory clinical result associated to a good movement of the transplanted joint is to be expected up to short-mid-term, overtime. Long term, the range of motion (ROM) is progressively decreased up to spontaneous arthrodesis in some cases, still the joint results pain free and patient’s perception is of a well functioning ankle. A deeper knowledge of the immunological behavior of transplanted cartilage is needed in order to improve the durability of this fascinating technique.     

5-year results of the 1.5 cm incision Achilles tendon repair

BackgroundTo study a hypothesis that the cost-effective 1.5 cm medial incision Achilles tendon repair technique will provide good functional outcomes which are maintained for over 5 years.MethodProspective study of 12 consecutive cases with a minimal 5-year follow-up were recruited from April 2008 to November 2010. Cases whom were mentally incompetent or those which required concomitant procedures were excluded. Outcomes measures included the numeric pain rating scale, motor power strength, range of motion, functional scoring using the AOFAS hindfoot score and patient’s self-assessment using the Foot and Ankle Outcome Score (FAOS).ResultNo re-ruptures or sural nerve injured were identified after a minimal 5-year follow-up. Pain was minimal at 0.5/10, calf power was 5/5 and ankle range was good (plantarflexion: 38°/dorsiflexion: 21°). The AOFAS hindfoot score was 97.4 and all 5 sub-categories of the Foot and Ankle Outcome Score (FAOS) were good.ConclusionThe 1.5 cm medial incision repair of the Achilles tendon is an economically sound surgical technique, with minimal complications, which gives good medium length functional outcomes.Level of evidenceIV.     

Individual didactic sessions or group lectures for teaching the foot and ankle to orthopaedic residents

BackgroundThe relative efficacy of individual didactic sessions or group lectures in teaching the foot and ankle to orthopaedic residents is unknown.MethodTen fourth year (R4) orthopaedic residents received individual didactic teaching sessions during a 1-month foot and ankle rotation, and 12 fifth year (R5) orthopaedic residents who had no foot and ankle rotation received a series of group lectures. Foot and ankle knowledge level was evaluated before and after the teaching programs with multiple choice tests.ResultsThe average test score for all residents was significantly improved from before to after the teaching programs (all residents: pre-test, 51 ± 11%; post-test, 66 ± 8%; P < 0.0001). There was no difference between the R4 and R5 resident groups in average pre-test score or post-test score. The improvement in test scores from the pre-test to the post-test was similar for the R4 and R5 resident groups.ConclusionsIndividual didactic sessions and group lectures were equally effective in encouraging learning and improving knowledge level of the foot and ankle. The key factors in significantly improving knowledge of the foot and ankle were the presence of a formal teaching program to stimulate learning and the availability of an active Foot and Ankle Service with dedicated attending foot and ankle subspecialist surgeons.     

Fragility fractures of the ankle in the elderly: Open reduction and internal fixation versus tibio-talo-calcaneal nailing: Short-term results of a prospective randomized-controlled study

IntroductionThe management of ankle fractures in the elderly remains unpredictable, secondary to their various co-morbidities. Although tibiotalocalcaneal (TTC) nailing has been an effective option for ankle arthrodesis due to ankle arthritis or Charcot arthropathy there are few reports regarding the use of TTC nail for the treatment of ankle fractures.PurposeAim of this study was to compare the results of ORIF versus TTC nailing for the treatment of unstable ankle fractures in the elderly. We hypothesized that the elderly may benefit from TTC nailing, as it allows the patient to be mobilized immediately after surgery and minimizes the risk of wound or bone problems.Patients and methodsThis was a prospective, randomized-controlled, comparative study. Between 2009 and 2015, 43 patients were treated with a TTC nail (Group A) and 44 with ORIF (Group B). The Olerud-Molander ankle score was obtained and intraoperative-postoperative complications, length of hospital stay, mobility status and reoperation rate were recorded. The nail fixation was performed with the TrigenR hindfoot nail after closed reduction. ORIF was performed, using a 1/3 tubular plate and 3.5 mm screws for the lateral malleolus and two 4.0 mm cannulated screws for the medial.ResultsMortality rate at one year was 13.9% for Group A and 18.1% for Group B. Mean follow-up was 14 months (12–18 m). There were no intraoperative complications. Three complications in Group A (8.1%) and twelve (33.3%) in Group B were encountered postoperatively (p < 0.05). There was significant shorter hospital stay in Group A (5.2 ± 3.1d) than in Group B (8.4 ± 5.2d). In Group A, 28 patients returned to their pre-injury mobility status (75.6%) while 9 declined one level of the mobility scale (24.3%). In Group B, 26 patients remained at the same mobility level (72.2%) and 10 declined one level (27.7%). There was no significant difference between the postoperative OMAS scores in the two Groups (56.9 ± 9.85 and 56.6 ± 9.3 respectively).ConclusionsWe believe that TTC nailing is a safe and effective method of treatment of unstable ankle fractures in the elderly because it has a low risk of complications and restores function and mobility allowing an immediate return to full weight-bearing.     

A new foot and ankle outcome score: Questionnaire based,subjective, Visual-Analogue-Scale,validated and computerized

Our purpose was to construct and validate a new score taking into consideration the flaws of existing scores.MethodsA new score named Visual-Analogue-Scale Foot and Ankle (VAS FA) with the following features was constructed: questionnaire based on 20 subjective questions, Visual-Analogue-Scale (VAS) based rating, computerized evaluation. The score was validated in 121 subjects. For validation, SF-36^® and Hannover Questionnaire (Q) were obtained and correlated with VAS FA.ResultsThe correlation VAS FA versus SF-36^® and Q (Pearson, all p-values <0.001, r ≥ 0.5) was sufficient for the total score and all score categories (pain, function, other complaints).The time needed for evaluating the scores was significantly lower for VAS FA than for SF-36^® and Q (Oneway-ANOVA, p < 0.001).ConclusionsThe introduced score is the first validated (on SF-36^®), subjective, VAS based outcome score for foot and ankle. The VAS FA is computerized which enables faster evaluation than SF-36^® or Q.