Osteochondral Lesions in Surgically Treated Hallux Valgus.
BACKGROUND
Patient dissatisfaction following surgical correction of hallux valgus remains a clinical problem. The aim of this study was to investigate articular erosion patterns of the first metatarsal head in patients with hallux valgus, to evaluate if the cartilage damage was associated with the degree of hallux valgus deformity, and to prospectively evaluate the effect on patient outcomes.


METHODS
Fifty-six consecutive feet undergoing surgical correction for hallux valgus were prospectively enrolled and followed for 24 months postoperatively. In addition to clinical and radiographic examinations, intraoperative measurements were obtained to quantify osteochondral lesion location, size, and grade of the first metatarsal head cartilage.


RESULTS
Fifty-one of 56 feet (91%) had osteochondral lesions. The mean number of zones affected was 2.9, and the mean maximum International Cartilage Repair Society (ICRS) scale lesion grade was 2.9 out of 4. A total of 44/56 (79%) completed a minimum of 24 months of follow-up. The grade of the lesion and the extent of the lesion did not have a strong correlation with the radiographic measures or clinical outcome scores.


CONCLUSIONS
This study showed a high prevalence of osteochondral lesions in patients undergoing operative correction of hallux valgus. Since the grade and the extent of the lesions did not have a strong correlation with the severity of the deformity or the clinical outcome, the significance of these lesions remains unknown.


METHODS
Level III, comparative series.
Saint Alphonsus Coughlin Foot & Ankle Clinic, Boise, ID, USA jrjast@gmail.com.
James R
JR
Jastifer
Saint Alphonsus Coughlin Foot & Ankle Clinic, Boise, ID, USA.
Michael J
MJ
Coughlin
UT-Erlanger Foot and Ankle Institute, Chattanooga, TN, USA.
Jesse F
JF
Doty
Tri-City Orthopaedics, Kennewick, WA, USA.
Faustin R
FR
Stevens
Saint Alphonsus Coughlin Foot & Ankle Clinic, Boise, ID, USA.
Christopher
C
Hirose
Allied Orthopaedics, Boise, ID, USA.
Travis J
TJ
Kemp
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006215:Hallux Valgus / Q000601:surgery*; D006801:Humans; D008297:Male; D008683:Metatarsophalangeal Joint / Q000601:surgery; D008875:Middle Aged; D010007:Osteochondritis / Q000453:epidemiology / Q000601:surgery*; D010027:Osteotomy; D010147:Pain Measurement; D011446:Prospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
bunion; hallux valgus; osteochondritis dissecans