title: Return to Sports and Physical Activities After the Modified Lapidus Procedure for Hallux Valgus in Young Patients.
abstract: BACKGROUND
  The modified Lapidus procedure has successfully relieved pain and corrected deformity in patients with hallux valgus, but its effect on participation in specific sports and physical activities remains unclear. Our goals were to assess sports and physical activities in young patients following the modified Lapidus procedure and to compare these with clinical outcomes.
  
  
  METHODS
  Fifty-eight eligible patients were identified from a retrospective registry review. Of these, 48 (83%) were reached for follow-up at a mean of 2.8 (range, 1.0 to 6.1) years and had a mean age at surgery of 37.3 (range, 14.1 to 49.3) years. Physical activity participation was evaluated with a new sports-specific, patient-administered questionnaire. Clinical outcomes were evaluated with the Foot and Ankle Outcome Score (FAOS) and compared to sports outcomes.
  
  
  RESULTS
  Patients participated in 26 different physical activities, consisting of 212 total physical activities preoperatively and 209 total postoperatively. The most common were walking, running, bicycling, and swimming. Compared to preoperatively, patients rated 29% of activities as less difficult, 52% as the same, and 19% as more difficult and rated participation levels as improved in 40%, the same in 41%, and impaired in 19%. Eighty-one percent of patients were satisfied with their operative outcome in regard to return to physical activity. Changes in the FAOS Pain subscore were significantly associated with improvements in physical activity difficulty (P < .05), and changes in the Pain, Sports, and QOL subscores were significantly associated with changes in physical activity participation levels (P < .05).
  
  
  CONCLUSIONS
  Four in 5 patients were able to participate in previous sports and physical activities, including high-impact activities, at their preoperative participation level or better after the modified Lapidus procedure, and were satisfied with surgery in regard to return to previous activity. However, several patients had increased difficulty and impaired participation in physical activity postoperatively. Altogether, this suggests that the procedure is a viable treatment option for hallux valgus in young, active patients.
  
  
  METHODS
  Level IV, retrospective case series.
authors.affiliation: Department of Foot and Ankle Surgery, Hospital for Special Surgery, NY, USA.
authors.forename: Aoife
authors.initials: A
authors.lastname: MacMahon
authors.affiliation: Department of Foot and Ankle Surgery, Hospital for Special Surgery, NY, USA.
authors.forename: John
authors.initials: J
authors.lastname: Karbassi
authors.affiliation: Department of Epidemiology and Biostatistics, Hospital for Special Surgery, NY, USA.
authors.forename: Jayme C
authors.initials: JC
authors.lastname: Burket
authors.affiliation: Department of Foot and Ankle Surgery, Hospital for Special Surgery, NY, USA.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Elliott
authors.affiliation: Department of Foot and Ankle Surgery, Hospital for Special Surgery, NY, USA.
authors.forename: David S
authors.initials: DS
authors.lastname: Levine
authors.affiliation: Department of Foot and Ankle Surgery, Hospital for Special Surgery, NY, USA.
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Roberts
authors.affiliation: Department of Foot and Ankle Surgery, Hospital for Special Surgery, NY, USA.
authors.forename: Jonathan T
authors.initials: JT
authors.lastname: Deland
authors.affiliation: Department of Foot and Ankle Surgery, Hospital for Special Surgery, NY, USA.
authors.forename: Martin J
authors.initials: MJ
authors.lastname: O'Malley
authors.affiliation: Department of Foot and Ankle Surgery, Hospital for Special Surgery, NY, USA.
authors.forename: Jeanne
authors.initials: J
authors.lastname: Yu
authors.affiliation: Department of Medicine, Hospital for Special Surgery, NY, USA.
authors.forename: Carol A
authors.initials: CA
authors.lastname: Mancuso
authors.affiliation: Department of Foot and Ankle Surgery, Hospital for Special Surgery, NY, USA elliss@hss.edu.
authors.forename: Scott J
authors.initials: SJ
authors.lastname: Ellis
mesh_terms: D000293:Adolescent; D000328:Adult; D001174:Arthrodesis; D015444:Exercise; D005260:Female; D033023:Foot Joints / Q000601:surgery; D006215:Hallux Valgus / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D017060:Patient Satisfaction; D012042:Registries; D012189:Retrospective Studies; D000068958:Return to Sport / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Lapidus procedure; hallux disorders; hallux valgus; outcome studies; physical activity; sports