Patient-reported outcomes using PROMIS after tarsal tunnel release surgery.

Abstract

Tarsal tunnel syndrome is an entrapment neuropathy of the tibial nerve and its branches in the tarsal tunnel. The literature on surgical release of the tarsal tunnel shows variable outcomes with no studies reporting validated patient reported outcomes. We aim to determine clinical response after tarsal tunnel release using the Patient-Reported Outcomes Measurement Information System (PROMIS). CPT code 28035 was used to identify patients who underwent isolated tarsal tunnel release (TTR) between 1/1/2015 and 12/15/2022 at a single institution. Patient demographic data and PROMIS physical function (PF), pain interference (PI), and depression scores were prospectively collected at the initial pre-operative clinic visit and in follow-up throughout the episode of care after TTR. The validated distribution-based method (1/2 sd) was used to assess minimal clinically important difference (MCID) and bivariate analysis was used to determine postoperative recovery. A total of 39 patients who underwent TTR were included. The mean t-score change (pre- to post-operation) was 7.2 for PF, -6.1 for PI, and -5.93 for depression. MCID thresholds were calculated as PF increase of 4.7, PI decrease of 3.9, and depression decrease of 5.1. Fourteen (35 %), 24(62 %), and 27 (69 %) patients reached MCID for PF, PI, and depression, respectively. No relationship was observed between space-occupying lesions and patient outcomes. This study provides validated outcomes after TTR. Though there is significant improvement after surgery, the patients still experience some pain and physical limitations.