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Research

INVESTIGATING PATIENT-REPORTED OUTCOME AND EXPERIENCE FOR FIRST METATARSAL SCARF+/− AKIN OSTEOTOMY FOR HALLUX VALGUS

European Orthopaedic Research Society (EORS) 2015, Annual Conference, 2–4 September 2015. Part 2.



Abstract

Background

Patient reported outcomes/experience measures have been a fundamental part of the NHS since 2009. Osteotomy procedures for hallux valgus produce varied outcomes due to their subjective nature. We used PROMS2.0, a semi-automated web-based system, which allows collection and analysis of outcome data, to assess what the patient reported outcome/experience measures for scarf+/− akin osteotomy for hallux valgus are at UHSM.

Methods

Prospective PROMS data was collected from November 2012 to February 2015. Scores used to asses outcomes included EQ-5D VAS, EQ-5D Health Index, and MOxFQ, collected pre-operatively and post-operatively. Patient Personal Experience (PPE-15) was collected postoperatively.

Results

40 patients (35F/5M) (19LT +21RT) had undergone an osteotomy. Average age was 60.7 years (Range 29–88). No bilateral procedures. The pre-op average MOXFQ scores for pain, walking and social interaction were: 51.6 (range 5–100), 51.4 (range 0–96) and 48.8 (range 0–100) respectively. Post operatively these improved to 24.4 (range 0–100), 22.9 (range 0–86) and 23.1 (range 0–88). All statistically significant. EQ5D score showed an improvement; with pre-op index average of 0.70. Post-op index average was 0.80. 11 patients were under 54 years old, 15 between 55–64, and 14 over 65. The greatest improvement was in the over 65s for MOxFQ and in the under 55s in EQ5D. 27/35 women showed improvement in all three MOxFQ domains, in contrast to all men. EQ5D also showed similar results. 65 patients filled out a PPE questionnaire. The results show overall average satisfaction of 72.9%.

Conclusion

The overall data suggests that scarf+/− akin osteotomy procedures for hallux valgus are a success. Data suggests that higher success rates are found in those over 65 and male patients.

Level of Evidence

Prospective case series- Level 3