Association of Visual Appearance on Outcomes After Hallux Valgus Surgery

Abstract

Background: In this study, our aim was to determine the effect of cosmetic improvement on patient satisfaction and functional scores in hallux valgus (HV) surgery. Methods: Preoperative foot photographs of 105 patients who had undergone chevron osteotomy for HV between 2016 and 2018 were taken. The patients were divided into 2 groups. Twenty-four months after surgery, the preoperative foot photographs were shown to patients in group 1 (n = 52) but not to patients in group 2 (n = 53). The groups were then compared using the visual analog scale (VAS), the American Orthopaedic Foot & Ankle Society Hallux Metatarsophalangeal-Interphalangeal (AOFAS Hallux MTP-IP), and the 36-Item Short Form Health Survey (SF-36) scores. Both groups were evaluated radiologically with preoperative and postoperative hallux valgus angles and intermetatarsal angles. Results: There was no difference between the 2 groups in terms of radiologic parameters either pre- or postoperatively, or AOFAS Hallux MTP-IP scores postoperatively. However, for group 1, the VAS was lower (0.4±0.8 vs 1.8±1.6, P = .003) and both the SF-36 physical functioning (88.3±18.1 vs 79.1±23.2, P = .017) and SF-36 mental health scores were higher (78.8±19 vs 69.2±16.3, P = .022). Conclusion: Visualizing improvement in the cosmetic appearance of the foot appears associated with patients’ perception of subjective pain and functional improvement. We recommend that preoperative foot photographs be taken and recorded. Level of Evidence: Level III, case-control study.

Development of a preoperative questionnaire to improve satisfaction with hallux valgus repair: A Delphi study

“…The panel validated all the items relating to aesthetics, confirming reports in the literature that many individuals seek repair to improve the aesthetic appearance of their foot [ 43 , 45 , 69 ]. Furthermore, aesthetic perceptions may influence pain levels and the functional benefits of surgery [ 69 ]. Since hallux valgus repair should not be performed for cosmetic reasons [ 59 ], such motives must be ascertained preoperatively.…”

Eligibility for knee arthroplasty is associated with increased risk of acquired hallux valgus - a Mendelian randomized study

“…when performing joint replacement surgery on patients with KOA and decide whether to intervene. Patients with HV have varying degrees of foot deformities, which can also cause pain and poor foot appearance [ 7 ]. Our findings serve as a reminder to clinicians to identify and intervene at an earlier stage in patients with osteoarthritis and hallux valgus.…”

“…A recent review estimated that worldwide, the prevalence of HV is as high as 23% in people aged 18-65 years and 35% in people over 65 years [ 6 ]. The HV deformity can lead to functional disabilities, such as foot pain, compromised gait, diminished balance, and foot deformity,which can significantly impact a person's ability to walk comfortably and perform daily activities [ 7 – 10 ]. A study [ 11 ] revealed a noteworthy disparity in the occurrence of HV and knee osteoarthritis (KOA) among female patients.…”

Foot & Ankle

“…Therefore, this study from Istanbul (Turkey) aimed to address the question of whether cosmetic appearance following surgery had any relationship with patient-reported functional outcome. 1 The authors reviewed the case However, the conclusions are somewhat undermined by the design. A study of this nature may be better performed with a prospective design and the two groups randomly assigned.…”