Surgery for adult acquired flatfoot due to posterior tibial tendon dysfunction reduces pain, improves function and health related quality of life

Cöster, Maria; Rosengren, Björn; Bremander, Ann; Karlsson, Magnus K.

doi:10.1016/j.fas.2015.04.003

Cited by 28 publications

(28 citation statements)

References 40 publications

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“…Recently, the validity, reliability, and responsiveness of the SEFAS was evaluated with good results both in patients with forefoot disorders and in patients with hindfoot and/or ankle disorders (Coster et al. 2012, 2014a, 2914b, 2015). An important strength of this study is that a reliable MIC value has been established for the same cohort of patients included in earlier validation studies (Coster et al.…”

Section: Discussionmentioning

confidence: 99%

“…An important strength of this study is that a reliable MIC value has been established for the same cohort of patients included in earlier validation studies (Coster et al. 2012, 2014a, 2014b, 2015), which makes the PROM suitable for registries and also useful in daily clinical practice.…”

Section: Discussionmentioning

confidence: 99%

“…The SEFAS has good measurement properties for evaluating both patients with forefoot disorders and patients with hindfoot/ankle disorders (Coster et al. 2012, 2014a, 2014b, 2015). …”

Section: Methodsmentioning

confidence: 99%

“…The SEFAS has good measurement properties regarding validity, reliability, and responsiveness in patients with a variety of foot and ankle disorders (Coster et al. 2012, 2014a, 2014b, 2015). In addition to these properties, it is also important to interpret the changes in scores of the PROM as a measure of treatment effect and clinical importance.…”

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confidence: 99%

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Minimally important change, measurement error, and responsiveness for the Self-Reported Foot and Ankle Score

et al. 2017

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Background and purposePatient-reported outcome measures (PROMs) are increasingly used to evaluate results in orthopedic surgery. To enhance good responsiveness with a PROM, the minimally important change (MIC) should be established. MIC reflects the smallest measured change in score that is perceived as being relevant by the patients. We assessed MIC for the Self-reported Foot and Ankle Score (SEFAS) used in Swedish national registries.Patients and methodsPatients with forefoot disorders (n = 83) or hindfoot/ankle disorders (n = 80) completed the SEFAS before surgery and 6 months after surgery. At 6 months also, a patient global assessment (PGA) scale—as external criterion—was completed. Measurement error was expressed as the standard error of a single determination. MIC was calculated by (1) median change scores in improved patients on the PGA scale, and (2) the best cutoff point (BCP) and area under the curve (AUC) using analysis of receiver operating characteristic curves (ROCs).ResultsThe change in mean summary score was the same, 9 (SD 9), in patients with forefoot disorders and in patients with hindfoot/ankle disorders. MIC for SEFAS in the total sample was 5 score points (IQR: 2–8) and the measurement error was 2.4. BCP was 5 and AUC was 0.8 (95% CI: 0.7–0.9).InterpretationAs previously shown, SEFAS has good responsiveness. The score change in SEFAS 6 months after surgery should exceed 5 score points in both forefoot patients and hindfoot/ankle patients to be considered as being clinically relevant.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…The SEFAS has good measurement properties for evaluating both patients with forefoot disorders and patients with hindfoot/ankle disorders (Coster et al. 2012, 2014a, 2014b, 2015). …”

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Minimally important change, measurement error, and responsiveness for the Self-Reported Foot and Ankle Score

et al. 2017

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“…13 Multiple techniques have been described for spring ligament reconstruction, including allograft, autograft (such as peroneus longus), and synthetic materials. 27,120 However, there are insufficient data to support which, if any, technique should be employed.…”

Section: Spring Ligament Reconstructionmentioning

confidence: 99%

Adult-Acquired Flatfoot Deformity

Henry

Shakked

Ellis

2019

Foot & Ankle Orthopaedics

135

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Adult-acquired flatfoot deformity (AAFD) comprises a wide spectrum of ligament and tendon failure that may result in significant deformity and disability. It is often associated with posterior tibial tendon deficiency (PTTD), which has been linked to multiple demographic factors, medical comorbidities, and genetic processes. AAFD is classified using stages I through IV. Nonoperative treatment modalities should always be attempted first and often provide resolution in stages I and II. Stage II, consisting of a wide range of flexible deformities, is typically treated operatively with a combination of soft tissue procedures and osteotomies. Stage III, which is characterized by a rigid flatfoot, typically warrants triple arthrodesis. Stage IV, where the flatfoot deformity involves the ankle joint, is treated with ankle arthrodesis or ankle arthroplasty with or without deltoid ligament reconstruction along with procedures to restore alignment of the foot. There is limited evidence as to the optimal procedure; thus, the surgical indications and techniques continue to be researched.

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