A Patient-Reported Outcome Based Comparison of Cheilectomy with and without Proximal Phalangeal Dorsiflexion Osteotomy for Hallux Rigidus
| Autor: | Rami Mizher, Robert Fuller, Jaeyoung Kim MD, Lavan Rajan BA, Agnes D. Cororaton, Prashanth Kumar MD, Tonya W. An MD, Jonathan T. Deland MD, Scott J. Ellis MD |
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| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: | |
| Zdroj: | Foot & Ankle Orthopaedics, Vol 7 (2022) |
| Druh dokumentu: | article |
| ISSN: | 2473-0114 24730114 |
| DOI: | 10.1177/2473011421S00814 |
| Popis: | Category: Midfoot/Forefoot Introduction/Purpose: Cheilectomy with and without Moberg osteotomy is used to improve function and remove pain in early- moderate stage hallux rigidus. The rise of patient-reported outcome measurements allows greater precision in comparing treatments as value-driven paradigms become increasingly important in clinical decision-making. This study provides the first comparison of patient-reported outcomes between isolated cheilectomy (C) and cheilectomy with Moberg (CM) osteotomy for hallux rigidus. We compared one and two-year PROM scores between patients who underwent C and CM for hallux rigidus using PROMIS, a validated patient-reported outcomes measurement system, and compared rates of complications and subsequent operations between the two groups. We hypothesized that patients who underwent CM would experience better clinical outcomes and fewer returns to the operating room than patients undergoing cheilectomy alone. Methods: A single-center, retrospective registry search identified all patients with preoperative PROMIS scores who underwent cheilectomy, with and without concomitant proximal phalangeal dorsiflexion osteotomy, for hallux rigidus between January 2016 and December 2020. An a priori power analysis determined that 24 patients per cohort were needed to detect a previously published minimum clinically important difference of 5.8 points on the PROMIS Physical Function scale with alpha = .05 and 80% power. However, all C patients were included. Because there were far fewer isolated cheilectomies (62), all C patients were compared with a commensurate number of consecutive CM cases (67) using preoperative, one-year, and two-year PROMIS scores for Physical Function, Pain Interference, Pain Intensity, Global Physical Health, Global Mental Health, and Depression, as well as complication and revision data from chart review. Age, sex, BMI, preoperative radiographic hallux rigidus grade, and preoperative range of motion were compared between the two cohorts. Results: PROMIS outcome data is given in Table 1. Both groups demonstrated statistically significant improvements in PROMIS Physical Function, Pain Interference, Pain Intensity, and Global Physical Health (P |
| Databáze: | Directory of Open Access Journals |
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