Clinician-based assessment of outcomes following foot and ankle surgery.
Evaluating subjective pain combined with objective physical findings (alignment/motion).
Historical monitoring of hindfoot and ankle disorders.
Clinical Objective
The AOFAS scale unique in that it combines patient-reported pain with objective clinical findings like joint range of motion and alignment.
Mechanism
The 3 Domains (100 Points)
Pain (Self-reported)40 points
Function (Activity/Motion)50 points
Alignment (Objective)10 points
Functional Items
Max walking distance (Blocks).
Walking surface (Even/Uneven).
Gait abnormality.
Sagittal/Hindfoot motion.
Ankle-hindfoot stability.
Clinical Edge
Rating Categories
90 – 100Excellent
80 – 89Good
70 – 79Fair
< 70Poor
Clinical Pearls
Alignment is scored 10 points for neutral, 5 for moderate malalignment, and 0 for severe.
Pain is the single highest-weighted domain (40%).
Critique: Because it is not purely patient-reported, it may suffer from "inter-rater variability" where different clinicians score the same patient differently.
After the Score
Management Decisions
1Poor Function Score: Focus on ankle proprioceptive training and sagittal range of motion (dorsiflexion).
2Persistent Pain: Evaluate for articular surface damage via MRI or weight-bearing CT.
3Alignment Deficits: Consider orthotic intervention to correct hindfoot varus/valgus.
Related Tools
Proof Base
Original Scale
Kitaoka HB, et al.
Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes.