Factors associated with patient satisfaction with foot and ankle surgery in a large prospective study.
BACKGROUND
There is minimal published research on outcomes and satisfaction with foot and ankle surgery.


OBJECTIVE
To investigate patient-reported outcomes and satisfaction, and investigate which factors influence satisfaction at 9 months following foot or ankle surgery.


METHODS
Prospective study of 671 adult patients having foot or ankle surgery. Pre-and post-surgery, patients self-completed MOXFQ, SF-36 and EQ-5D questionnaires. Using ratings to a satisfaction item, patients who were 'very pleased' with the outcome were compared with everyone else, using multiple logistic regression, regarding their pre-, peri- and post-operative characteristics.


RESULTS
Of 628 eligible patients, 491 (73%) completed pre-and post-operative questionnaires. Following adjustment, satisfaction with surgery was influenced by patients' perceptions of their foot/ankle's appearance (OR 0.12, 95% CIs 0.06-0.23, p<0.001); wearable range of shoes (OR 0.36, 95% CIs 0.17-0.79, p=0.01); continued foot/ankle pain (OR 0.06, 95% CIs 0.03-0.14, p<0.001); impairment in Social-Interaction (MOXFQ SI scale) (OR 0.98, 95% CIs 0.96-0.99, p=0.009). The final explanatory model explained 67% of the variance in patient satisfaction.


CONCLUSIONS
Foot appearance, wearable shoe range, the (full) alleviation of pain and the ability/confidence to interact socially are crucial to peoples' satisfaction with their foot or ankle surgery.
Department of Public Health, University of Oxford and the Nuffield Orthopaedic Centre, Oxford, United Kingdom. jill.dawson@dph.ox.ac.uk
Jill
J
Dawson
Irene
I
Boller
Helen
H
Doll
Grahame
G
Lavis
Robert J
RJ
Sharp
Paul
P
Cooke
Crispin
C
Jenkinson
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000842:Ankle / Q000601:surgery*; D004954:Esthetics; D005260:Female; D005528:Foot / Q000601:surgery*; D006801:Humans; D007398:Interpersonal Relations; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000706:statistics & numerical data; D010146:Pain / Q000601:surgery; D017060:Patient Satisfaction; D011446:Prospective Studies; D012775:Shoes; D011795:Surveys and Questionnaires; D006113:United Kingdom; D055815:Young Adult