J Foot Ankle Res. 2025 Dec;18(4):e70084. doi: 10.1002/jfa2.70084.
ABSTRACT
BACKGROUND: This study investigated the quality and clinical outcomes of the British Orthopaedic Foot and Ankle Society (BOFAS) registry first metatarsophalangeal joint (MTPJ) arthrodesis pathway.
METHODS: A prospective cohort study using data derived from the BOFAS registry. Adults aged ≥ 18 years with a record of undergoing first MTPJ arthrodesis in the UK from 29/08/2014 to 31/10/2019. The pre- and post-treatment pathway was evaluated by analysing Patient Reported Outcome Measures (PROMs) at baseline, 6 months and 12 months intervals. Consistency of data capture and completeness were explored using means, SD, medians and IQR for continuous variables and frequencies for categorical variables.
RESULTS: The mean age of the study population (n = 459) was 64.1 (± 12.1) years and 98.9% of the study cohort were female. Completeness of data collection was low for some items (e.g., medication 46%, surgical procedures 52%). Baseline completion of PROMs was moderate with 52.5% of participants providing MOXFQ (Manchester-Oxford Foot Questionnaire) pain and walking/standing scores at baseline. However, follow-up response rates declined substantially to 27.2% at 6 months and 15.7% at 12 months. Improvement in PROMs by 12 months following surgery was statistically and clinically significant (p < 0.001), with median scores of 10 [IQR: 0-20] for MOXFQ pain, 5.5 [0-21] for walking/standing, 0 [0-19] for social interaction, 5 [1-31] for NRS pain and 0.8 [0.7-1.0] for EQ-5D-5L.
CONCLUSION: The analysis highlights the clinical benefits of first metatarsophalangeal joint (first MTPJ) fusion surgery, with improvements in pain intensity, walking/standing ability, social interaction and quality of life. The BOFAS registry serves as a valuable tool for collecting patient-reported outcome measure (PROM) data, providing important insights into treatment effectiveness and participant well-being. Strengthening the data collection capabilities of the BOFAS registry could further enhance our understanding of the benefits of first MTPJ fusion and inform future treatment strategies.
PMID:41025702 | DOI:10.1002/jfa2.70084
