79. PREFERENCE-BASED QUALITY OF LIFE IN END-STAGE ANKLE ARTHRITIS, TOTAL ANKLE ARTHROPLASTY, AND ANKLE ARTHODESIS

Abstract

Purpose: To describe the pre- and one-year post-operative preference-based, health related quality of life (health state values) among a cohort of subjects with end-stage ankle arthritis treated with total ankle arthroplasty or ankle arthrodesis. This short-term study is not intended to compare the efficacy of arthoplasty and arthrodesis.

Method: The Short-Form 36 (SF-36) was prospectively completed by subjects enrolled in the Canadian Orthopaedic Foot and Ankle Society Multicentered Ankle Arthritis Outcome Study between 2003 and 2005. Preference-based quality of life was assessed pre-operatively and at one-year post-procedure using health state values (HSVs) derived from the SF-36 transformation described by Brazier (SF-6D). The SF-6D scores are anchored at 1.0 (full health) and at 0 (death). Basic patient demographic and treatment information was also collected. The decision to perform arthroplasty or arthrodesis was made by the attending surgeon.

Results: Two hundred four of the 214 eligible subjects had complete preoperative SF-36 data to allow transformation to SF-6D values. One-year follow-up was available for 114 of the participants. The mean age at surgery of the included subjects was 58.9 +/− 13.3 years. Of the patients with one-year follow-up, 56% were male and 59% had received total ankle arthroplasty. These demographics did not differ from the original preoperative cohort. The mean SF-6D score among all subjects with end-stage ankle arthrosis was 0.66 (95% CI 0.65 – 0.68). At one-year, the mean HSVs of the total ankle arthroplasty and ankle arthrodesis groups were 0.73 (95% CI 0.71 – 0.76) and 0.73 (95% CI 0.70 – 0.75), respectively. The reported pre-operative scores describe health states below normative data for the US population (0.76 +/− 0.01 for females, ages 55–64).

Conclusion: These are the first available HSVs for a cohort of patients with end-stage ankle arthritis treated with total ankle arthroplasty or ankle arthrodesis. These data demonstrate an improvement in preference-based quality of life following ankle arthroplasty or arthrodesis. At one-year follow-up, patient reported HSVs approach age-matched US norms.