Linzy Houchen-Wolloff1,2, Amirah Essop-Adam3, Rachel Calver1, Chloe Dudson4, Jitendra Mangwani4,5. 1. Physiotherapy Department, University Hospitals of Leicester NHS Trust, UK. 2. Department of Respiratory Science, University of Leicester, UK. 3. Department of Cardiovascular Sciences, University of Leicester, UK. 4. Orthopaedics, University Hospitals of Leicester NHS Trust, UK. 5. Academic Team of Musculoskeletal Surgery, University Hospitals of Leicester NHS Trust, UK.
Abstract
OBJECTIVE: There has recently been a paradigm shift in the management of Achilles tendon rupture and ankle fracture rehabilitation with emphasis on early mobilisation. There is, however, no consensus on post-operative rehabilitation for hind/mid-foot fusion and reconstructive surgery.The aim was to scope the post-operative rehabilitation practices of UK foot and ankle surgeons and allied health professionals (AHPs). METHODS: A 10 question online survey was sent to UK surgeons and AHPs via specialist interest groups in February 2019. Quantitative and qualitative data were analysed. RESULTS: 117 surgeons and 55 AHPs responded. There was good agreement between survey responses in the 2 groups. Fifty percent reported that they followed a local post-operative rehabilitation protocol. More than half of respondents (57%) reported that not all patients were referred for post-operative rehabilitation. There was a wide variation in the time point at which patients were instructed to weight bear (2 weeks to >12-weeks). Non-union was a concern of early mobilisation as highlighted by 62% of respondents. Qualitative themes identified were: treatment tailored to individual patients, lack of knowledge about the patient journey, treatment tailored to surgeon preferences, lack of a pathway, variation in practice. CONCLUSIONS: There is a wide variation in the post-op rehabilitation of patients undergoing this surgery in the UK, with a lack of published research in this area. Early rehabilitation could improve patient outcomes, yet the risk of non-union is a major concern. Further research in the form of a multicentre trial is warranted to answer this research question.
OBJECTIVE: There has recently been a paradigm shift in the management of Achilles tendon rupture and ankle fracture rehabilitation with emphasis on early mobilisation. There is, however, no consensus on post-operative rehabilitation for hind/mid-foot fusion and reconstructive surgery.The aim was to scope the post-operative rehabilitation practices of UK foot and ankle surgeons and allied health professionals (AHPs). METHODS: A 10 question online survey was sent to UK surgeons and AHPs via specialist interest groups in February 2019. Quantitative and qualitative data were analysed. RESULTS: 117 surgeons and 55 AHPs responded. There was good agreement between survey responses in the 2 groups. Fifty percent reported that they followed a local post-operative rehabilitation protocol. More than half of respondents (57%) reported that not all patients were referred for post-operative rehabilitation. There was a wide variation in the time point at which patients were instructed to weight bear (2 weeks to >12-weeks). Non-union was a concern of early mobilisation as highlighted by 62% of respondents. Qualitative themes identified were: treatment tailored to individual patients, lack of knowledge about the patient journey, treatment tailored to surgeon preferences, lack of a pathway, variation in practice. CONCLUSIONS: There is a wide variation in the post-op rehabilitation of patients undergoing this surgery in the UK, with a lack of published research in this area. Early rehabilitation could improve patient outcomes, yet the risk of non-union is a major concern. Further research in the form of a multicentre trial is warranted to answer this research question.
Authors: Joshua W Hustedt; Daniel J Blizzard; Michael R Baumgaertner; Michael P Leslie; Jonathan N Grauer Journal: Orthopedics Date: 2012-07-01 Impact factor: 1.390
Authors: Diederik P J Smeeing; Roderick M Houwert; Jan Paul Briet; Johannes C Kelder; Michiel J M Segers; Egbert Jan M M Verleisdonk; Luke P H Leenen; Falco Hietbrink Journal: PLoS One Date: 2015-02-19 Impact factor: 3.240