Analysis of Patient-Reported Outcomes Following Triple Arthrodesis: A Minimum Two-Year Followup

Abstract

Category: Hindfoot Introduction/Purpose: Adult acquired flatfoot deformity (AAFD) is a debilitating condition that is common in the United States. Triple arthrodesis (TA) is a treatment option reserved for advanced disease. Evidence on patient outcomes following this procedure remains limited. This study aims to report patient-reported outcomes following TA via patient reported outcome measurement information systems (PROMIS). Secondary aims are to delineate any demographics or patient characteristics that significantly impact PROMIS scoring. Methods: In this single institution study, we identified all patients who underwent triple arthrodesis between 2014 and 2021 based on CPT coding. Patients who underwent a TA procedure for AAFD with a minimum of 24 months follow-up were eligible for inclusion in this study. Patients under the age of 18, those undergoing revision surgeries, or those with pathologies other than AAFD were excluded from this study. Patient demographics and surgical complications were collected through chart review. The Patient Reported Outcomes Measurement Information System (PROMIS) survey and Foot Function Index (FFI) scores were collected via telephone interview. PROMIS scores were analyzed with a Type III “SS” ANOVA test to stratify independent risk factors and account for confounding variables. Results: 49 patients (43%) submitted responses to the survey. Patient outcomes were collected at an average of 5.50 years postoperatively. There were no significant differences in the rates of complications among any of the variables analyzed. The average PROMIS physical function score was 38.35, the average pain interference score was 61.52, and the average depression score was 49.82. Males and patients with prior foot and ankle procedures had significant increases in PROMIS physical function scores (p 50 years old had significantly higher FFI pain, disability, and total scores (p <.05). VAS scores decreased preoperatively to postoperatively from 5.4 to 2.6. Conclusion: Our study is the first to examine variables significantly impacting PROMIS, FFI and VAS scores for patients undergoing TA for AAFD. Treatment of AAFD with TA appears to be beneficial in long-term reduction of pain. This study is one of the largest to date involving patient reported outcomes following TA and can serve as a prognostic tool for physicians to use when counseling patients prior to this procedure.