Abstract
Background The American Orthopaedic Foot and Ankle Society (AOFAS) score is one scoring system used to evaluate and monitor the progress of patients following foot and ankle surgery. The aim of this study was to evaluate the trend of AOFAS score over a period of time and correlate with quality-adjusted life-year (QALY) score, which is a valid and reliable scoring system.
Method All patients undergoing surgery under one foot and ankle surgeon from a period of January 2001 to July 2003 were reviewed. The pre-operative AOFAS and QALY scores and post-operative at 3, 6, 12 months and yearly were collected prospectively.
Results This study includes 205 surgical procedures in 159 patients. This included 40 patients with 41 feet in the ankle-hindfoot group; 15 patients with 15 feet in the midfoot group; 83 patients with 114 feet in the hallux group and 29 patients with 35 feet in the lesser toes group. The mean age of the patients was 51.9 yrs.
The general trend of the AOFAS graph shows a mean of 45.3 pre-operatively which rises to 72.4 at 3 month and a peak of 77.1 at 6 months only to fall to 75.7 at 12 months. This fall though seemingly marginal was significant (p< 0.001) Kendall’s rank correlation was used to correlate the AOFAS and QALY score. The 6-month AOFAS score was found to have higher correlation with the final QALY score (τ =0.423) than the 12-month AOFAS score (τ =0.236).
Conclusion AOFAS score correlates with subjective and functional results as determined by QALY score. The role of assessing AOFAS at 3 months does not seem to be justified. There is a deterioration in score at 12 months. Post-operative scores at 6 months should be sufficient to assess the outcome.
Correspondence should be addressed to BOFSS, c/o Wrightington Wigan and Leigh NHS Trust, Hall Lane, Appley Bridge, Wigan, Lancashire WN7 9EP.
