Emory University School of Medicine, Atlanta, GA, USA.
Emory University Orthopaedics and Spine Center, Atlanta, GA, USA.
Foot Ankle Int. 2020 May;41(5):501-507. doi: 10.1177/1071100720907034. Epub 2020 Mar 4.
Surgery for degenerative foot and ankle conditions often results in a lengthy recovery. Current outcome measures do not accurately assess postoperative mobility, especially in older patients. The Life-Space Assessment (LSA), a questionnaire quantifying patients' mobility after a medical event, was used in this study to assess perioperative mobility in total hip arthroplasty (THA) and foot and ankle surgery patients. We hypothesized that patients undergoing elective foot and ankle surgery would have greater postoperative mobility limitation than THA patients.
Preoperative, 3-month, and 6-month postoperative LSA data were collected from THA and foot and ankle cohorts. Twelve-month postoperative data were obtained for the foot and ankle group as well. Patient demographics were recorded, and data were analyzed using a Mann-Whitney test.
Twenty-eight degenerative foot and ankle operative patients and 38 THA patients met inclusion criteria. Only patients aged ≥60 years were included in this study. The mean preoperative LSA score was lower in the foot and ankle group (68.8) compared with THA (74.0), although the difference was not statistically significant ( = .602). THA patients showed a significant increase in LSA score from preoperative (74) to 6 months postoperation (95.9) ( = .003); however, foot and ankle patients showed no significant difference between preoperative (68.8) and 6-month (61.2) scores ( = .468). Twelve months postoperatively, foot and ankle patients showed improvement in LSA score (88.3) compared with preoperation ( = .065).
Compared with THA, recovery of mobility after foot and ankle surgery was slower. THA patients exhibited improved mobility as early as 3 months after surgery, whereas foot and ankle patients did not show full improvement until 12 months. This work will assist the foot and ankle specialist in educating patients about challenges in mobility during their recovery from surgery.
Level II, prospective cohort study.
退行性足踝疾病的手术通常需要较长的恢复期。目前的疗效评估方法无法准确评估术后活动能力，尤其是对于老年患者。本研究使用生活空间评估（LSA）问卷来评估全髋关节置换术（THA）和足踝手术患者的围手术期活动能力。我们假设择期行足踝手术的患者术后活动能力受限程度大于 THA 患者。
收集 THA 和足踝两组患者的术前、术后 3 个月和 6 个月的 LSA 数据。同时收集足踝组患者术后 12 个月的数据。记录患者的人口统计学资料，并使用 Mann-Whitney U 检验进行数据分析。
28 例退行性足踝手术患者和 38 例 THA 患者符合纳入标准。本研究仅纳入年龄≥60 岁的患者。与 THA 组（74.0）相比，足踝组患者的术前 LSA 评分（68.8）较低，尽管差异无统计学意义（Z=-1.382，P=.171）。THA 患者的 LSA 评分从术前（74）到术后 6 个月（95.9）显著增加（Z=-3.024，P=.002）；然而，足踝组患者的术前（68.8）和术后 6 个月（61.2）评分之间差异无统计学意义（Z=-1.524，P=.127）。术后 12 个月，足踝组患者的 LSA 评分（88.3）较术前（Z=-2.233，P=.025）有所改善。
与 THA 相比，足踝手术后的活动能力恢复较慢。THA 患者术后 3 个月即可改善活动能力，而足踝患者直到术后 12 个月才完全改善。这项工作将帮助足踝外科医生向患者说明手术恢复期活动能力方面的挑战。
Ⅱ级，前瞻性队列研究。
