McCahon Joseph A S, Massaglia Joseph, Moncman Tara G, Riebesell Samantha, Parekh Selene G, Pedowitz David I, Daniel Joseph N
Jefferson Health-New Jersey, Stratford, New Jersey.
Rothman Orthopaedic Institute, Philadelphia, Pennsylvania.
Foot Ankle Spec. 2024 Sep 18:19386400241274601. doi: 10.1177/19386400241274601.
Resiliency is the ability to recover from stressful events and has been shown to correlate with patient outcomes following certain orthopaedic procedures. The purpose of this study was to determine the relationship between resiliency and outcomes following TAA.
A retrospective analysis of patients undergoing primary TAA between April 2015 and September 2022 was performed (N = 83). Data included demographics, comorbidities, complications, preoperative and postoperative visual analog scale (VAS) pain and Foot and Ankle Ability Measure (FAAM) functional scores, Brief Resilience Scale (BRS) scores, and surgical satisfaction. Patients were defined as having low resilience (LR), normal resilience (NR), or high resilience (HR) based on a BRS score of <3, 3-4.30, and >4.3, respectively.
High resilience patients had significantly higher postoperative FAAM ADL, Sports, and Overall scores as well as a significantly greater increase from preoperative scores compared with LR and NR patients. Low resilience patients had significantly lower FAAM Sports and Overall scores compared with normal and high resilience patients. BRS scores positively correlated with postoperative FAAM scores. We found no difference in satisfaction or VAS between the 3 cohorts. Multivariate regression analysis identified BRS scores to be an independent predictor for greater changes in FAAM scores following TAA.
Although functional improvements following TAA are expected, patients with higher resilience at baseline are more likely to experience greater improvements in functional outcomes following surgery.
Level III.
恢复力是指从压力事件中恢复的能力，并且已被证明与某些骨科手术后的患者预后相关。本研究的目的是确定全踝关节置换术（TAA）后恢复力与预后之间的关系。
对2015年4月至2022年9月期间接受初次TAA的患者进行回顾性分析（N = 83）。数据包括人口统计学资料、合并症、并发症、术前和术后视觉模拟量表（VAS）疼痛评分以及足踝能力测量（FAAM）功能评分、简易恢复力量表（BRS）评分和手术满意度。根据BRS评分分别<3、3 - 4.30和>4.3，将患者定义为恢复力低（LR）、恢复力正常（NR）或恢复力高（HR）。
与LR和NR患者相比，恢复力高的患者术后FAAM日常生活活动（ADL）、运动和总分显著更高，且与术前评分相比增加幅度显著更大。与恢复力正常和高的患者相比，恢复力低的患者FAAM运动和总分显著更低。BRS评分与术后FAAM评分呈正相关。我们发现三组之间在满意度或VAS方面没有差异。多变量回归分析确定BRS评分是TAA后FAAM评分有更大变化的独立预测因素。
尽管预计TAA后功能会有所改善，但基线恢复力较高的患者术后功能结局更有可能有更大改善。
三级。
