Abstract

Background: Patient reported outcome measures (PROMs) and patient reported experience measures (PREMs) are fundamental to the NHS. We used PROMs2.0, a semi-automated web-based system to assess the patient reported outcomes and experience measures between different operative treatments for hallux rigidus.

Patients and methods: PROMs scores used - EQ-5D VAS and EQ-5D Health Index, and MOxFQ. Data collected pre- post-operatively (follow-up 6 months) PREMs data collected using Picker Patient Experience questionnaire (PPE-15) postoperatively. Average union time- 6weeks. No complications/ infections. No conversions from cheilectomy to fusion.

Results:

Cheilectomy- Average MOxFQ improved- pain: 33.5->25.0 (p=0.084),

walking/standing: 27.6->24.3 (p=0.249),

social interaction: 24.9->21.9(p=0.327).

Average EQ-5D regressed: Index: 0.72->0.70 (p=0.392).

VAS: 86.8->80.4. (p=0.158)

Fusion-Average MOxFQ improved- pain: 50.7->9.7,

walking/standing: 49.1->16.1,

social interaction: 48.4->20.1 (all p< 0.0001)

Average EQ-5D improved: Index:0.68->0.83 (p=0.003).

VAS: 72.5->83.6 (p=0.014)

Fusion outcomes with OA grades- 4/4 patients with grade 2 improved, 11/12 with grade 3. Cheilectomy, 2/2- grade one improved, 3/7 with grade 2 and 0/1 with grade 3. (p< 0.0001). 17 patients (10 fusion/7 cheilectomy) did the PPE-questionnaire. Results show satisfactory experience for both groups

Conclusion: Both procedures show improved outcomes. Fusions have greater improvements than cheilectomy. Higher grades of OA do better with fusion.