title: Critical evaluation of outcome scales assessment of lateral ankle ligament reconstruction.
abstract: BACKGROUND
  Outcome following foot and ankle surgery can be assessed by disease- and region-specific scores. Many scoring systems exist, making comparison among studies difficult. The present study focused on outcome measures for a common foot and ankle abnormality and compared the results obtained by 2 disease-specific and 2 body region-specific scores.
  
  
  METHODS
  We reviewed 41 patients who underwent lateral ankle ligament reconstruction. Four outcome scales were administered simultaneously: the Cumberland Ankle Instability Tool (CAIT) and the Chronic Ankle Instability Scale (CAIS), which are disease specific, and the American Orthopedic Foot & Ankle Society (AOFAS) hindfoot scale and the Foot and Ankle Ability Measure (FAAM), which are both body region-specific. The degree of correlation between scores was assessed by Pearson's correlation coefficient. Nonparametric tests, the Kruskal-Wallis and the Mann-Whitney test for pairwise comparison of the scores, were performed.
  
  
  RESULTS
  A significant difference (P < .005) was observed between the CAIS and the AOFAS score (P = .0002), between the CAIS and the FAAM 1 (P = .0001), and between the CAIT and the AOFAS score (P = .0003).
  
  
  CONCLUSIONS
  This study compared the performances of 4 disease- and body region-specific scoring systems. We demonstrated a correlation between the 4 administered scoring systems and notable differences between the results given by each of them. Disease-specific scores appeared more accurate than body region-specific scores. A strong correlation between the AOFAS score and the other scales was observed. The FAAM seemed a good compromise because it offered the possibility to evaluate the patient according to his or her own functional demand.
  
  
  CONCLUSIONS
  The present study contributes to the development of more critical and accurate outcome assesment methods in foot and ankle surgery.
authors.affiliation: Centre Hospitalier Universitaire Vaudois CHUV and University of Lausanne UNIL, Department of Orthopedic Surgery and Traumatology, 1011 Lausanne, Switzerland.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Burn
authors.forename: Yannick
authors.initials: Y
authors.lastname: Buerer
authors.forename: Swati
authors.initials: S
authors.lastname: Chopra
authors.forename: Michaela
authors.initials: M
authors.lastname: Winkler
authors.forename: Xavier
authors.initials: X
authors.lastname: Crevoisier
mesh_terms: D000293:Adolescent; D000328:Adult; D000843:Ankle Joint; D015331:Cohort Studies; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007593:Joint Instability / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D017844:Lateral Ligament, Ankle / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D020127:Recovery of Function; D015203:Reproducibility of Results; D055815:Young Adult
keywords: Broström-Gould; ankle instability; lateral ankle ligament repair; outcome score