Symptom and Disability Measurement by Common Foot and Ankle–Specific Outcome Rating Scales

Background: Well-designed foot and ankle clinical outcomes research requires region-specific subjective outcome measures. Many foot and ankle–specific instruments are now available. Determining which instruments to choose is daunting. We present a patient survey to determine the most relevant questions pertaining to them. Methods: Sixteen foot and ankle–specific outcome instruments were chosen based on popularity, emphasizing valid, reliable, responsive scores. Subjective portions were consolidated and given to 109 patients with osteochondral lesion of the talus (OLT) (39), ankle instability (35), and ankle arthritis (35). Outcome instruments were measured according to 4 criteria: number of questions endorsed by 51%, number with high mean importance, number with low mean importance, and number with the highest-ranking frequency importance product. Instruments were then ranked based on relative score, with the highest scores indicating the instrument was the most useful for that sample. Results: The Foot and Ankle Outcome Score (FAOS) achieved the highest score in all 4 categories for OLT, followed by Foot and Ankle Ability Measure (FAAM) and American Academy of Orthopaedic Surgeons (AAOS) Foot and Ankle Score. The FAOS achieved the highest score in all 4 categories for ankle instability, followed by FAAM and AAOS. For osteoarthritis, the FAOS achieved the highest relative score followed by FAAM and AAOS. The AOF, Ankle Osteoarthritis Score, and AAS are instruments commonly used that had lower relative scores. Conclusion: The FAOS, FAAM, and AAOS Foot and Ankle Score contain several items important to patients with osteochondral lesions of the talus, ankle instability, and ankle osteoarthritis. Level of Evidence: Level II, prospective comparative study.