Patient satisfaction and patient-reported outcome measures after primary ankle arthrodesis: 2-year results from the Swedish Ankle Registry

BACKGROUND AND PURPOSE: Ankle arthrodesis (AA) and total ankle replacement are the 2 main surgical treatment options for advanced ankle arthritis but information is scarce on satisfaction and patient-reported outcome measures (PROMs) after surgery. We aimed to evaluate postoperative satisfaction, changes in PROMs from before to 2 years after AA, and factors associated with the outcome. METHODS: This is a national registry-based observational study using the Swedish Ankle Registry. We identified 1,145 patients who underwent AA between 2008 and 2020 who answered a question on satisfaction, and between 662 and 702 patients who answered pre- and 2-year postoperative PROMs (SElf reported Foot and Ankle Score [SEFAS], EQ-5D index, and EQ-5D VAS). We analyzed changes in scores and associations between surgical/patient factors (including preoperative PROMs) and the outcomes satisfaction/postoperative PROM score. RESULTS: All mean PROM scores improved from before to 2 years postoperatively (all P < 0.001). 69% of the patients were satisfied with the procedure, 15% uncertain, and 16% dissatisfied. Satisfaction was associated with higher preoperative SEFAS score and dissatisfaction with lower preoperative SEFAS score. Higher SEFAS score was associated with male sex and osteoarthritis (compared with rheumatoid arthritis), while higher EQ-5D index and EQ-5D VAS scores were associated with male sex, posttraumatic arthritis, osteoarthritis (compared with rheumatoid arthritis), and higher age. CONCLUSION: The majority (69%) of patients treated with AA are satisfied with the procedure and a higher preoperative SEFAS score is associated with postoperative satisfaction. We speculate that preoperative SEFAS score may be useful for predicting postoperative outcomes and will facilitate preoperative patient discussions on expected results.