Table 1 Themes, topics and research questions identified from scoping survey
Topic | Question |
|---|---|
Theme: Health economics and service delivery | |
Service Delivery | Is Podiatric Surgery efficient and cost effective compared to other providers of foot surgery? |
What methods of service promotion are most effective in Podiatric Surgery? | |
Promoting our discipline: what is the understanding of Podiatric Surgery by other healthcare professionals? How do we raise awareness? | |
What is the place of Podiatric Surgery in mainstream medical care? | |
What has been the impact of independent prescribing on Podiatric Surgery? | |
Population Health | What is the recurrence rate of hallux valgus following correction via osteotomy? |
How does Podiatric Surgery benefit the health of the population? | |
What are the demographics of patients accessing Podiatric Surgery services and do they represent all groups in the local community? | |
Covid-19 | What is the incidence of post-surgery venous thromboembolism in relation to Covid-19 vaccine in Podiatric Surgery? |
What role has Podiatric Surgery played during the pandemic? | |
What operational changes to Podiatric Surgery have occurred during the pandemic? | |
Theme: Patient satisfaction and patient reported outcome measures | |
Patient satisfaction | What is the effect of hallux valgus deformity on quality of life? |
Does hallux valgus surgery reduce falls in elderly patients? | |
How does quality of life improve following elective foot surgery? | |
What are the patient experiences of day case foot surgery? | |
Patient reported outcome measures | Is the Manchester Oxford Foot Questionnaire valid in elective foot surgery other than hallux valgus correction? |
Are the Short-form -36 and EuroQol-5D valid in elective foot surgery? | |
What is the benefit of utilising PASCOM-10 (National audit database) to improve large scale outcome data? | |
How does the patient’s verbal report of surgical success relate to quantitative patient reported outcomes measures? | |
Theme: Treatment | |
Conservative treatment | Steroid injection therapy – short-, medium-, and long- term outcomes |
Is there a place for platelet-rich plasma in end-stage osteoarthritis management? | |
Is hyaluronic acid, platelet-rich plasma, or steroid injection therapy most effective in 1stmetatarsophlanageal joint osteoarthritis? | |
Pre-operative assessment | Is there a place for prehabilitation clinics prior to hallux valgus correction? |
Should we routinely be completing toe pressures on all elective surgery patients? Do toe pressures in elective cases accurately indicate wound healing potential? | |
Does routine toe pressure assessment improve early diagnosis of vascular issues prior to elective foot surgery? | |
Antibiotic prophylaxis in elective foot surgery: is it required? What modality is best? Risk stratification tool? | |
Venous thromboembolism in elective foot surgery | |
What is the most appropriate peri-operative management of immunosuppressive medications in elective foot surgery? | |
Surgical treatment-forefoot | Deep transverse ligament release vs neurectomy: A comparative study |
What is the consensus on neuroma surgery: plantar vs dorsal incision, single vs double? | |
What are the latest techniques in forefoot surgery? | |
Randomised study of hammer toe fusion versus arthroplasty | |
Review of long-term outcomes of implants (E.g., 1stmetatarsophalangeal joint, interphlex, proximal interphalangeal joint) | |
Minimally invasive surgery versus open lesser metatarsal surgery-what are the outcomes? | |
Surgical treatment-midfoot | What is the most effective Lapidus fixation option? |
What are the financial implications of different fixation techniques for Lapidus? | |
Is the trephine grafting technique superior to traditional joint preparation in midfoot fusion? | |
Surgical treatment-rearfoot | What are the advancements in rearfoot surgery? |
What is the success of Achilles Tendon lengthening in improving forefoot pain? | |
What is the most effective fixation method for Talonavicular joint fusion? | |
Post-operative management | Review of post-operative regimen for procedures-what’s the consensus throughout the profession? |
What post-operative protocols are used following surgery (procedure specific), and do they affect patient reported outcome measures and time to recovery? | |
Do post-operative range of motion exercises following hallux valgus correction improve patient outcomes? | |
What is the most effective strategy for reducing digital swelling post-operatively? | |
What are the best modalities for reducing post-operative scarring? | |
Impact factors | Does Vitamin D affect union rates post-operatively: what are the thresholds? |
Does smoking directly impact surgical outcomes in foot surgery? | |
Does the use of a bone stimulator improve the speed of bony union following foot and ankle fusions? | |
Getting it right first time (GIRFT) | Is the World Health Organisation checklist fit for purpose? |
What patient safety tools are in use in Podiatric Surgery, and have they reduced errors? | |
Minimising risk: does the imaging report match the request? Is it reducing costs? Are imaging modalities being used appropriately? | |
Are current thoughts regarding common risks of surgery true, or are they outdated or incorrect? | |
Theme: limb salvage surgery | |
Cost-efficiency | What are the short-, medium-, and long- term benefits of our involvement in limb salvage surgery- does it help? Does it save money? What quantifiable data can we publish to develop this arm of the profession? |
Is our involvement in limb salvage surgery beneficial to patients and financially favourable to trusts: a long-term study of outcomes and finances? | |
What models are currently being used in the management of the diabetic foot? Is one more cost effective than the other and do they affect the patient pathway and outcomes? | |
Multi-disciplinary Team | Advancements in the diabetic foot-working with vascular in an acute setting? |
What is the understanding of Podiatric Surgery in the wider multidisciplinary team? | |
Do we meet the national criteria? | |
Surgery / Treatment | Do variations in peri-operative management affect outcomes in the diabetic foot? |
What are the multi-centre outcomes of Podiatric Surgery in limb salvage of the diabetic foot? | |
Elective prophylactic and curative approaches in limb salvage surgery, how do we compare our data using PASCOM-10 as a tool? | |
Patient experience | What is the psychological impact of diabetic foot ulceration and lower limb amputation? |
How does Podiatric Surgery benefit the health of the population in the at-risk foot? | |
What is the patient experience of Podiatric Surgery in the management of their diabetic foot ulcer? | |
Did Covid-19 delay patients seeking treatment for diabetic foot ulceration and how has this affected prognosis and outcomes? | |