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- Talk
- 23/09/2021
- UK
Ankle Injury Rehabilitation (AIR): A Multicentre Randomised Controlled Trial and Economic Evaluation
Description
In this presentation, Becky Kearney represents the Ankle Injury Rehabilitation (AIR) team, funded by the National Institute for Health Research, discussing the common issue of ankle fractures, which account for approximately 9% of trauma cases in the UK, with around 120,000 occurrences annually. Traditionally treated with casting to immobilize the bones for proper healing, this method often leads to joint stiffness and muscle wastage. In response, a shift towards using removable braces has been adopted, allowing for early movement and exercise to potentially improve recovery outcomes.
Kearney introduces their study aimed at investigating if the Olerud-Molander Ankle Score (OMAS) differs between patients treated with traditional casting versus those with removable braces at 16 weeks post-injury. The extensive trial, conducted across 20 sites in the UK from 2017 to 2019, randomized participants who were either operated on or treated non-operatively. The research team set clear outcome measures, including OMAS, the Manchester-Oxford Foot Questionnaire, and the Disability Rating Index, while screening over 3,144 participants for eligibility, with significant exclusions documented.
The randomized control trial included 669 patients, with high compliance rates to their allocated treatments. Ultimately, the results revealed no significant difference in OMAS scores, and similar findings were noted across other outcome measures. Separate analyses for surgical and non-surgical patients also showed no differences in recovery outcomes. Kearney notes that while initial complications such as wound infections appeared slightly higher in brace patients, no statistically significant difference was found between the two groups. Financial analysis indicated that while casts are cheaper, braces may provide better overall cost-effectiveness due to improved quality of life post-treatment.
The key conclusion drawn by Kearney is that the removable brace is safe and cost-effective, reinforcing the need for further research on optimal rehabilitation strategies following the initial immobilization period. The presentation concludes with acknowledgments to the AIR team and collaborators for their contributions to the study, emphasizing the importance of this data in improving patient care.