Comparison of patient reported outcomes using the Manchester-Oxford Foot Questionnaire and surgical complications following total ankle replacement in rheumatoid arthritis versus osteoarthritis.

IF 1.3 4区 医学 Q2 Medicine
S Kay Robert, Neo Chryssa, M Leow Jun, Shalaby Hisham, McKinley John
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引用次数: 0

Abstract

Total ankle replacement (TAR) is an alternative to ankle fusion for treatment of end stage ankle arthritis. It has been hypothesized that patients with rheumatoid arthritis may experience inferior outcomes due to altered immune response and low bone quality. Previous studies using the American Orthopaedic Foot & Ankle Society (AOFAS) score suggest patient reported outcomes following TAR for osteoarthritis (OA) versus rheumatoid arthritis (RA) are indifferent, however the AOFAS score has limitations and has largely been superseded by the Manchester-Oxford Foot Questionnaire (MOXFQ) score, which demonstrates favourable data characteristics. The aims of the present study were to compare outcomes in RA versus OA following TAR using the MOXFQ and describe associated complication rates. This single-center cohort study included 114 patients (143 TARs) who underwent primary TAR from 2010 to 2023. Data included patient demographics, comorbidities, satisfaction and MOXFQ. Multivariate logistic regression was used to assess differences in outcomes between OA versus RA adjusting for demographic covariates. Change in MOXFQ score following TAR was equal between the RA and OA group after adjusting for demographic co-variates (OR, 1.01 [95 % CI, 0.99-10.3], p = 0.284). RA was associated with increased risk of wound healing complications (OR 11.75 [95 %CI, 1.06-130.32], p = 0.045). RA status did not influence the likelihood of requiring a revision operation, though this finding lacked sufficient statistical power. RA status was not demonstrated to significantly affect change in MOXFQ score following TAR. Wound healing complications were higher in RA patients, while other surgical and medical complications rates were equivalent.

比较使用曼彻斯特-牛津足问卷的患者报告的结果和类风湿关节炎与骨关节炎全踝关节置换术后的手术并发症。
全踝关节置换术(TAR)是踝关节融合术治疗终末期踝关节关节炎的替代方法。据推测,类风湿关节炎患者可能由于免疫反应改变和骨质量低下而经历较差的结果。先前使用美国骨科足踝协会(AOFAS)评分的研究表明,骨关节炎(OA)和类风湿性关节炎(RA)患者报告的TAR后结果是不同的,然而AOFAS评分有局限性,并且在很大程度上被曼彻斯特-牛津足问卷(MOXFQ)评分所取代,该评分显示出有利的数据特征。本研究的目的是使用MOXFQ比较TAR后RA和OA的结果,并描述相关的并发症发生率。这项单中心队列研究纳入了2010-2023年间接受初级TAR治疗的114例患者(143例TAR患者)。数据包括患者人口统计、合并症、满意度和MOXFQ。采用多变量逻辑回归来评估OA与RA在调整人口统计学协变量后的结果差异。经人口统计学协变量调整后,RA组和OA组在TAR后MOXFQ评分的变化相等(OR为1.01 [95% CI, 0.99-10.3], p=0.284)。RA与伤口愈合并发症风险增加相关(OR 11.75 [95%CI, 1.06-130.32], p=0.045)。RA状态不影响需要翻修手术的可能性,尽管这一发现缺乏足够的统计能力。RA状态未被证明显著影响TAR后MOXFQ评分的变化。RA患者的伤口愈合并发症较高,而其他手术和医学并发症发生率相当。
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来源期刊
Journal of Foot & Ankle Surgery
Journal of Foot & Ankle Surgery ORTHOPEDICS-SURGERY
CiteScore
2.30
自引率
7.70%
发文量
234
审稿时长
29.8 weeks
期刊介绍: The Journal of Foot & Ankle Surgery is the leading source for original, clinically-focused articles on the surgical and medical management of the foot and ankle. Each bi-monthly, peer-reviewed issue addresses relevant topics to the profession, such as: adult reconstruction of the forefoot; adult reconstruction of the hindfoot and ankle; diabetes; medicine/rheumatology; pediatrics; research; sports medicine; trauma; and tumors.
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