title: Patient reported outcomes six months following surgical treatment of end stage hallux rigidus in a community based podiatric surgery service.
abstract: BACKGROUND
  End stage hallux rigidus can be treated surgically by arthrodesis, excisional arthroplasty and implant arthroplasty. Evaluation of these techniques has focused on clinical indicators such as radiographic, complications and subjective examination. Little attention has been given to health related quality of life and the use of patient reported outcome measures is still infrequent.
  
  
  METHODS
  An evaluation was undertaken in a community based podiatric surgery service. utilising the PASCOM-10 online database. Patient reported outcomes were captured on the day of surgery and six months' post operation in the form of the Manchester Oxford Foot Questionnaire (MOXFQ) and the PASCOM PSQ-10 patient satisfaction questionnaire.
  
  
  RESULTS
  Between 1st November 2011 and 31st October 2014, there were 157 admissions for treatment of end-stage hallux rigidus; 61 implant arthroplasties, 53 Keller's arthroplasties and 43 arthrodeses. The age range was 45-89, 72% female. MOXFQ scores improved across all domains for all procedures, the score change exceeded the minimal clinically important change threshold of 13 points and large effect sizes were achieved (range 1.10-3.179). Patient satisfaction was good for all procedures with mean PSQ-10 scores of 81.89 for arthrodesis; 82.36 for implants and 81.89 for Keller's. Few serious complications were encountered though the overall incidence of complications was high for the implant group.
  
  
  CONCLUSIONS
  This evaluation found all three procedures are clinically effective with high levels of patient satisfaction and improved quality of life. Although the implant arthroplasty is associated with a higher incidence of complications, this is not reflected in the outcomes achieved.
authors.affiliation: Department of Podiatric Surgery, Nottinghamshire Healthcare NHS Foundation Trust, Park House Health and Social Care Centre, 61 Burton Road, Nottingham, NG4 3DQ, United Kingdom. Electronic address: Anthony.maher@nottshc.nhs.uk.
authors.forename: Anthony John
authors.initials: AJ
authors.lastname: Maher
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001174:Arthrodesis; D019643:Arthroplasty, Replacement; D005260:Female; D020859:Hallux Rigidus / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D000071066:Patient Reported Outcome Measures; D017060:Patient Satisfaction; D011788:Quality of Life; D012189:Retrospective Studies; D011795:Surveys and Questionnaires
keywords: Arthrodesis; Hallux rigidus; Implant arthroplasty; Keller arthroplasty; MOXFQ; PASCOM-10