Hiflex Foot Gear improves Quality of life in patients with osteoarthritis of the ankle

Abstract

Category: Ankle Arthritis Introduction/Purpose: There are few reports describing conservative therapy for ankle osteoarthritis. Hiflex Foot Gear (HFG) is a custom-made polyethylene ankle–foot orthosis developed to permit slight mobility of the ankle while providing adequate ankle support. The purpose of this study was to validate the hypothesis that HFG improves the quality of life (QOL) in patients with ankle osteoarthritis.Subjects and methods. Methods: Ten ankles from eight patients (one man, seven women) diagnosed with ankle osteoarthritis at this hospital, prescribed an HFG, and observed for follow-up for at least 3 months were included in this study. The patients’ mean age was 69.9 (range: 46?85) years. Patients were classified as Takakura–Tanaka stage IIIa (2 ankles), stage IIIb (2 ankles), stage IV (6 ankles), with a mean observation period of 8.9 (range: 3?13) months. Clinical evaluations were made before and 3 months after wearing the orthosis. The ankle/hindfoot scale of the Japanese Society for Surgery of the Foot (JSSF) Standard Rating System and the Self-Administered Foot Evaluation Questionnaire (SAFE-Q) subscale of the Japanese Orthopaedic Association/Japanese Society for Surgery of the Foot, respectively, were used for making evaluations. Scores were compared using a paired t-test. Results: JSSF scores improved from 55.1 points at baseline to 71.4 points after wearing the HFG (p < 0.001). According to the SAFE-Q subscales, changes after wearing the HFG were as follows: 28.9 to 61.9 points for items related to pain (p < 0.001), 36.9 to 53.7 points for those related to physical function and daily life (p = 0.001), 31.3 to 58.9 points for those related to social functions (p = 0.002), and from 31.3 to 65.0 points for those related to overall perception of health (p < 0.001); items related to shoes showed no substantial change (from 52.1 to 53.6 points). Conclusion: Our results revealed that wearing the HFG improved pain in patients with severe ankle osteoarthritis. Retained flexibility in the ankle range of motion was believed to be the factor underlying improvements in physical function and daily life, social functions, and overall perception of health. HFG is a potential option for conservative therapy in patients who cannot obtain sufficient pain control during the preoperative waiting period or in those who do not wish to undergo surgery.