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Patient Characteristics of Possible Responders and Nonresponders to Total Ankle Arthroplasty.

Publication ,  Journal Article
Steele, JR; Cunningham, DJ; Green, CL; Risoli, TJ; DeOrio, JK; Nunley, JA; Easley, ME; Adams, SB
Published in: Foot Ankle Int
August 2020

BACKGROUND: Characteristics of responders, or those who achieve a clinical improvement above the level of a minimal clinically important difference, have not been defined for total ankle arthroplasty (TAA). The purpose of this study was to determine patient characteristics that distinguish possible responders from possible nonresponders after TAA using criteria established for other arthroplasty surgeries. METHODS: Patients undergoing TAA who were enrolled into a prospective study at a single academic center evaluating patient-reported outcomes were included. Patients were characterized as possible responders if the relative or absolute improvement in their 2-year follow-up Short Musculoskeletal Function Assessment (SMFA) function score was at least 50% or 20, respectively, compared with their preoperative score, consistent with Outcome Measures in Rheumatoid Arthritis Clinical Trials and the Osteoarthritis Research Society International (OMERACT-OARSI) responder criteria. Patient factors were then associated with possible responder or nonresponder status and a multivariable analysis was performed. A total of 491 patients with complete data and 2-year follow-up were included in this study. RESULTS: Multivariable analysis demonstrated that a higher baseline 36-Item Short-Form Survey (SF-36) mental component summary (MCS) score (OR [95% CI], 1.02 [1.01, 1.04]; P = .003), indicating better mental health, was associated with being a possible responder to TAA. The presence of rheumatic disease (OR [95% CI], 0.38 [0.22, 0.67]; P = .001) was a significant predictor of being a possible nonresponder. CONCLUSION: Our data reveal that a higher baseline SF-36 MCS score was associated with increased improvement in SMFA function scores, while rheumatic disease was associated with worse improvement in SMFA function scores after TAA. Patients with rheumatic disease or poor mental health may not achieve as favorable results after TAA and should be counseled appropriately. LEVEL OF EVIDENCE: Level III, retrospective comparative study.

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Published In

Foot Ankle Int

DOI

EISSN

1944-7876

Publication Date

August 2020

Volume

41

Issue

8

Start / End Page

893 / 900

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Severity of Illness Index
  • Recovery of Function
  • Patient Reported Outcome Measures
  • Osteoarthritis
  • Orthopedics
  • Multivariate Analysis
  • Middle Aged
  • Mental Health
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Steele, J. R., Cunningham, D. J., Green, C. L., Risoli, T. J., DeOrio, J. K., Nunley, J. A., … Adams, S. B. (2020). Patient Characteristics of Possible Responders and Nonresponders to Total Ankle Arthroplasty. Foot Ankle Int, 41(8), 893–900. https://doi.org/10.1177/1071100720926123
Steele, John R., Daniel J. Cunningham, Cynthia L. Green, Thomas J. Risoli, James K. DeOrio, James A. Nunley, Mark E. Easley, and Samuel B. Adams. “Patient Characteristics of Possible Responders and Nonresponders to Total Ankle Arthroplasty.Foot Ankle Int 41, no. 8 (August 2020): 893–900. https://doi.org/10.1177/1071100720926123.
Steele JR, Cunningham DJ, Green CL, Risoli TJ, DeOrio JK, Nunley JA, et al. Patient Characteristics of Possible Responders and Nonresponders to Total Ankle Arthroplasty. Foot Ankle Int. 2020 Aug;41(8):893–900.
Steele, John R., et al. “Patient Characteristics of Possible Responders and Nonresponders to Total Ankle Arthroplasty.Foot Ankle Int, vol. 41, no. 8, Aug. 2020, pp. 893–900. Pubmed, doi:10.1177/1071100720926123.
Steele JR, Cunningham DJ, Green CL, Risoli TJ, DeOrio JK, Nunley JA, Easley ME, Adams SB. Patient Characteristics of Possible Responders and Nonresponders to Total Ankle Arthroplasty. Foot Ankle Int. 2020 Aug;41(8):893–900.
Journal cover image

Published In

Foot Ankle Int

DOI

EISSN

1944-7876

Publication Date

August 2020

Volume

41

Issue

8

Start / End Page

893 / 900

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Severity of Illness Index
  • Recovery of Function
  • Patient Reported Outcome Measures
  • Osteoarthritis
  • Orthopedics
  • Multivariate Analysis
  • Middle Aged
  • Mental Health
  • Male