Evidence map›Paper›PMID 36503504›Full record

ArticleJournal of foot and ankle research2022

"I could have a proper ankle" - a qualitative study of patients' perceptions of total ankle replacement and ankle fusion surgery.

Anna M Anderson, Lara S Chapman, Heidi J Siddle, Sue Watson, Jane Klugerman, Deborah Antcliff, Anne-Maree Keenan, Claire L Brockett

Abstract read
In one paragraph

Article in Journal of foot and ankle research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Anna M AndersonLeeds Institute of Rheumatic & Musculoskeletal Medicine, University of Leeds, Leeds, UK. a.anderson@leeds.ac.uk.ORCID http://orcid.org/0000-0002-4048-6880
Lara S ChapmanLeeds Institute of Rheumatic & Musculoskeletal Medicine, University of Leeds, Leeds, UK.
Heidi J SiddleLeeds Institute of Rheumatic & Musculoskeletal Medicine, University of Leeds, Leeds, UK.
Sue WatsonLeeds National Institute for Health and Care Research Biomedical Research Centre, Leeds, UK.
Jane KlugermanLeeds National Institute for Health and Care Research Biomedical Research Centre, Leeds, UK.
Deborah AntcliffSchool of Healthcare, University of Leeds, Leeds, UK.
Anne-Maree KeenanSchool of Healthcare, University of Leeds, Leeds, UK.
Claire L BrockettInstitute of Medical and Biological Engineering, School of Mechanical Engineering, University of Leeds, Leeds, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEnd-stage ankle osteoarthritis typically causes severe pain and impaired function. Surgical treatment involves total ankle replacement (TAR) or ankle fusion. Definitive evidence about which procedure is optimal is lacking. No previous studies have thoroughly explored patients' experiences across the entire TAR/ankle fusion pathway. This study aimed to address this gap by exploring perceptions of surgery, education, rehabilitation and outcomes among patients who had undergone TAR or ankle fusion.

methodsSeven participants were purposively selected from an orthopaedic centre in northern England (3 females, 4 males). Participants had undergone primary TAR without revision (n = 2), TAR requiring revision (n = 3) or ankle fusion (n = 2). Each participant completed a single semi-structured interview. Interviews were digitally recorded, transcribed verbatim and analysed thematically.

resultsThree themes, each with two subthemes, were identified: decision-making (seeking help; surgical options), perceptions of support (information/education; clinical support) and impact on the individual (personal circumstances and beliefs; post-operative outcomes). Pain affecting participants' valued activities was key to their decision to seek help. Participants' decision between TAR and ankle fusion was influenced by multiple factors. Concerns regarding the lack of joint flexibility following fusion were highlighted, with some participants perceiving TAR as a "proper ankle" that would enable them to avoid limping. Participants obtained information from various sources, with most feeling that the education from their care team was inadequate. Participants' individual circumstances and beliefs influenced their decision-making and perceptions of their post-operative outcomes. Finally, whilst most participants were pleased with their outcomes, some experienced substantial ongoing problems such as difficulty walking and chronic pain.

conclusionsThis study demonstrates the importance of providing adequate education about TAR and ankle fusion to enable patients to make informed decisions. Most participants felt that the education and clinical support they received did not fully meet their needs. Participants' personal circumstances and beliefs had a strong influence on their decision-making and perceptions of their post-operative outcomes, highlighting the need to personally tailor education and clinical support. Future work with a larger sample of patients and other key stakeholders is required to develop consensus-based guidelines on pre- and post-operative support for patients undergoing TAR/ankle fusion.

Indexed as

Arthroplasty, Replacement, AnkleOsteoarthritisAnkle JointArthrodesisFemaleHumansMalePainAnkle fusionPatient educationRehabilitationTotal ankle replacement

Identifiers

PMID36503504
PMCPMC9743489

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.