Do MOXFQ scores change over time? A retrospective study of podiatric surgery outcomes.

BackgroundRecording patient-reported outcome measurements six months after surgery using PASCOM-10 is common practice in podiatric surgery in the United Kingdom. This study aims to establish if the health-related quality of life after foot surgery is changed at the 12- month point. MethodAn audit of patient-reported outcomes following foot surgery was undertaken. Electronic case notes were examined, and 236 patients were identified over 1 year. Patients completed the Manchester Oxford Foot/Ankle Questionnaire (MOXFQ) pre-surgery, at six months post-operatively (in person/telephone conversation) and were then invited by letter to complete this again at 12 months post-operatively. Results91 participants (39%) completed both post-operative questionnaires (66 females 25 males), 45% completed a six-month questionnaire only and 61% completed a 12-month questionnaire. The results demonstrate a significant score change between the three time points and across the three MOXFQ domains of walking/standing, pain and social interaction (0.353, F [6, 356] = 40.59, p <.001), and a further interaction with gender (0.435, F [6,352] = 30.23, p <.001). An average, positive change in health-related quality of life (HRQOL) across all domains was the greatest from pre-surgery to six months post-surgery at 78% improved, and then decreased to 62% improved at 12 months post-surgery. Females experience lower HRQOL before surgery, at 6 months and at 12-month post-operation time points but gain the greatest improvement over pre-operative scores at 30%. ConclusionA patient-centred approach is key in foot surgery, patient-reported health-related quality of life changes significantly at different time points. In this review, the overall health- related quality of life improved with surgery at the six- and 12-month point, but with some deterioration at 12 months. A short period of recovery may not yield genuine long-term patient- reported outcomes, and an increase to a minimum of 12 months is recommended from the more common six months. However, the different methods of collecting post-operative data at various time points may have had an influence on scores. Level of clinical evidence:4