The Journal of Bone and Joint Surgery (American). 2008;90:499-505.
doi:10.2106/JBJS.F.01299
© 2008 The Journal of Bone and Joint Surgery, Inc.
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Comparison of Health-Related Quality of Life Between Patients with End-Stage Ankle and Hip Arthrosis

Mark Glazebrook, PhD, MD, FRCS(C)1, Tim Daniels, MD, FRCS(C)2, Alastair Younger, MSc, MD, FRCS3, C.J. Foote, BSc1, Murray Penner, MD, FRCS(C)3, Kevin Wing, MD, FRCS(C)3, Johnny Lau, MSc, MD, FRCS(C)2, Ross Leighton, MD, FRCS(C)1 and Michael Dunbar, PhD, MD, FRCS(C)1

1 Division of Orthopaedics, Room 4867 Halifax Infirmary, Queen Elizabeth II Health Sciences Centre, 1796 Summer Street, Halifax, NS B3H 3A7, Canada. E-mail address for M. Glazebrook: markglazebr{at}ns.sympatico.ca
2 Division of Orthopaedics, St. Michael's Hospital, University of Toronto, 55 Queen Street East, Toronto, ON M5C 1R6, Canada
3 401 1160 Burrard Street, Vancouver, BC V6Z 2E8, Canada

Investigation performed at Dalhousie University/Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada, St. Michael's Hospital, Toronto, Ontario, Canada, University of British Columbia, Vancouver, British Columbia, Canada, and Memorial University/St. John's Health Science Centre, St. John's, Newfoundland, Canada

Disclosure: In support of their research for or preparation of this work, one or more of the authors received, in any one year, outside funding or grants in excess of $10,000 from an AOFAS Competition Grant, a Zimmer Competition Grant–University of Toronto, and the Rehabilitation Solutions Research Advisory Board, and of less than $10,000 from a Summer Research Grant for Medical Students. In addition, one or more of the authors or a member of his or her immediate family received, in any one year, payments or other benefits in excess of $10,000 or a commitment or agreement to provide such benefits from a commercial entity (Zimmer). No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.

Background: End-stage ankle arthrosis is one of the leading causes of chronic disability in North America. Information on this condition is limited. The amount of pain and the reduction in health-related quality of life and function have not been quantified with use of universal outcome measures. The purpose of the present study was to compare the extent of pain, loss of function, and health-related quality of life in two cohorts of patients waiting for the surgical treatment of end-stage ankle or hip arthrosis.

Methods: One hundred and thirty patients with end-stage ankle arthrosis who were awaiting total ankle arthroplasty or ankle arthrodesis were recruited through a Canadian Orthopaedic Foot and Ankle Society multicenter study. All patients prospectively completed the Short Form-36 (SF-36) generic outcome instrument. This cohort was compared with a similar cohort of 130 patients with end-stage hip arthrosis, randomly selected from an existing prospective joint replacement database, who had completed an SF-36 questionnaire prospectively from 2000 to 2005.

Results: In both groups, the scores for all SF-36 subscales were approximately two standard deviations below normal population scores. Patients with ankle arthrosis had significantly worse mental component summary scores (p < 0.05), role-physical scores (p < 0.05), and general health scores (p < 0.05). Patients with hip arthrosis reported significantly lower physical function scores (p < 0.05), although the SF-36 physical component summary score was not significantly different between the two groups. The SF-36 physical component summary, bodily pain, vitality, role-emotional, social functioning, and mental health subscale scores were equally affected in both cohorts.

Conclusions: The mental and physical disability associated with end-stage ankle arthrosis is at least as severe as that associated with end-stage hip arthrosis.

Level of Evidence: Prognostic Level I. See Instructions to Authors for a complete description of levels of evidence.


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