title: Surgery for the correction of hallux valgus: minimum five-year results with a validated patient-reported outcome tool and regression analysis.
abstract: This study sought to determine the medium-term patient-reported and radiographic outcomes in patients undergoing surgery for hallux valgus. A total of 118 patients (162 feet) underwent surgery for hallux valgus between January 2008 and June 2009. The Manchester-Oxford Foot Questionnaire (MOXFQ), a validated tool for the assessment of outcome after surgery for hallux valgus, was used and patient satisfaction was sought. The medical records and radiographs were reviewed retrospectively. At a mean of 5.2 years (4.7 to 6.0) post-operatively, the median combined MOXFQ score was 7.8 (IQR:0 to 32.8). The median domain scores for pain, walking/standing, and social interaction were 10 (IQR: 0 to 45), 0 (IQR: 0 to 32.1) and 6.3 (IQR: 0 to 25) respectively. A total of 119 procedures (73.9%, in 90 patients) were reported as satisfactory but only 53 feet (32.7%, in 43 patients) were completely asymptomatic. The mean (SD) correction of hallux valgus, intermetatarsal, and distal metatarsal articular angles was 18.5° (8.8°), 5.7° (3.3°), and 16.6° (8.8°), respectively. Multivariable regression analysis identified that an American Association of Anesthesiologists grade of >1 (Incident Rate Ratio (IRR) = 1.67, p-value = 0.011) and recurrent deformity (IRR = 1.77, p-value = 0.003) were associated with significantly worse MOXFQ scores. No correlation was found between the severity of deformity, the type, or degree of surgical correction and the outcome. When using a validated outcome score for the assessment of outcome after surgery for hallux valgus, the long-term results are worse than expected when compared with the short- and mid-term outcomes, with 25.9% of patients dissatisfied at a mean follow-up of 5.2 years.
authors: Western Health, Melbourne, Australia.
authors: A
authors: A
authors: Chong
authors: Western Health, Melbourne, Australia.
authors: N
authors: N
authors: Nazarian
authors: Western Health, Melbourne, Australia.
authors: J
authors: J
authors: Chandrananth
authors: Northern Health, Melbourne, Australia.
authors: M
authors: M
authors: Tacey
authors: Western Health, Melbourne, Australia.
authors: D
authors: D
authors: Shepherd
authors: Western Health, Melbourne, Australia.
authors: P
authors: P
authors: Tran
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006215:Hallux Valgus / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017060:Patient Satisfaction; D011859:Radiography; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Bunion; Hallux Valgus; Manchester-Oxford Foot Questionnaire (MOXFQ); Outcomes; Surgery