Retrospective Cohort Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Nov 18, 2016; 7(11): 746-751
Published online Nov 18, 2016. doi: 10.5312/wjo.v7.i11.746
Return to physical activity after gastrocnemius recession
Camelia Tang Qian Ying, Sean Lai Wei Hong, Bing Howe Lee, Gowreeson Thevendran
Camelia Tang Qian Ying, Sean Lai Wei Hong, Bing Howe Lee, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
Gowreeson Thevendran, Department of Orthopeadic Surgery, Tan Tock Seng Hospital, Singapore 308433, Singapore
Author contributions: Tang Qian Ying C, Lai Wei Hong S, Lee BH and Thevendran G jointly designed and performed the research, analysed the data and wrote the paper.
Institutional review board statement: The study was reviewed and approved for publication by the institutional reviewer.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All authors have no conflict of interest related to the manuscript.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Camelia Tang Qian Ying, Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Singapore 117597, Singapore. camelia.cam.93@gmail.com
Telephone: +65-93215779
Received: July 18, 2016
Peer-review started: July 21, 2016
First decision: August 5, 2016
Revised: August 18, 2016
Accepted: September 7, 2016
Article in press: September 8, 2016
Published online: November 18, 2016
Abstract
AIM

To prospectively investigate the time taken and patients’ ability to resume preoperative level of physical activity after gastrocnemius recession.

METHODS

Endoscopic gastrocnemius recession (EGR) was performed on 48 feet in 46 consecutive sportspersons, with a minimum follow-up of 24 mo. The Halasi Ankle Activity Score was used to quantify the level of physical activity. Time taken to return to work and physical activity was recorded. Functional outcomes were evaluated using the short form 36 (SF-36), American Orthopedic Foot and Ankle Society (AOFAS) Hindfoot score and modified Olerud and Molander (O and M) scores respectively. Patient’s satisfaction and pain experienced were assessed using a modified Likert scale and visual analogue scales. P-value < 0.05 was considered statistically significant.

RESULTS

Ninety-one percent (n = 42) of all patients returned to their preoperative level of physical activity after EGR. The mean time for return to physical activity was 7.5 (2-24) mo. Ninety-eight percent (n = 45) of all patients were able to return to their preoperative employment status, with a mean time of 3.6 (1-12) mo. Ninety-six percent (n = 23) of all patients with an activity score > 2 were able to resume their preoperative level of physical activity in mean time of 8.8 mo, as compared to 86% (n = 19) of patients whose activity score was ≤ 2, with mean time of 6.1 mo. Significant improvements were noted in SF-36, AOFAS hindfoot and modified O and M scores. Ninety percent of all patients rated good or very good outcomes on the Likert scale.

CONCLUSION

The majority of patients were able to return to their pre-operative level of sporting activity after EGR.

Keywords: Endoscopic gastrocnemius release, Time return to work, Return to physical activity, Post-operative outcomes, Foot and ankle

Core tip: Whilst the biomechanical advantage of surgical off-loading from gastrocnemius recession is well proven, the potential for weak push-off strength post-operatively continues to be debated. We are not aware of any published literature investigating the impact of the gastrocnemius recession procedure on the ability to return to physical activity. This study aims to investigate the hypothesis that the majority of patients will be unable to return to their pre-operative level of physical activity after a gastrocnemius recession procedure.