Effect of Age on Clinical and Radiological Outcomes of Hallux Valgus Surgery

Abstract

Background: The prevalence of hallux valgus increases with age. However, no studies have compared the effectiveness of surgical correction among different age groups. This study investigated the influence of age on clinical and radiological outcomes following hallux valgus surgery. Methods: Patients who underwent correction for hallux valgus at an academic hospital were stratified into 3 age groups: younger (<50 years), middle-aged (50-59 years), and older (≥60 years). Functional outcomes and satisfaction questionnaires were collected preoperatively and at 6 months and 2 years postoperatively. Radiological recurrence and reoperations were recorded at follow-up. There were 193 patients (93% female): 34 younger, 74 middle-aged, and 85 older. Results: The preoperative hallux valgus angle was significantly greater in older patients ( P < .001). The older group had 3 perioperative complications ( P = .144) and showed a trend toward a longer hospital stay ( P = .083). There was no difference in visual analog scale, American Orthopaedic Foot & Ankle Society score, or SF-36 among the groups at 6 months or 2 years. Using multiple regression, age was not associated with any outcome score. The satisfaction rates were 82%, 78%, and 83% in the young, middle-aged, and older groups, respectively ( P = .698). There was no difference in the number of reoperations at a mean follow-up of 9.2 ± 2.2 years ( P = .778), and no patients underwent reoperation for recurrent hallux valgus. The risk of recurrence was 5 times higher in older patients compared with younger patients (OR, 5.15; 95% CI, 1.10-24.03; P = .037). Conclusion: Age did not influence the perioperative, functional, or subjective outcomes following hallux valgus surgery. However, older patients should be counseled on the higher risk of recurrence following surgical correction. Level of Evidence: Therapeutic, level III, retrospective comparative series.

Hallux Valgus Recurrence After Simple Bunionectomy: Algorithm Treatment

“…Finally, for elderly patients with comorbidities and limited functional demands, we consider the Keller-Brandes procedure [8,42]. This technique has potential complications of transfer metatarsalgia, shortening of the hallux, and loss of hallux purchase [43][44][45][46].…”

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

“…Hallux valgus is more frequent in women than men and in older than younger people [ 4 , 58 ], furthermore, women tend to have greater difficulties with shoe fitting because of hallux valgus than men. Although age does not appear to have an impact on surgical outcomes [ 64 , 65 ], older people tend to have a more sedentary lifestyle than younger people [ 66 ] and may therefore have different functional expectations that should be considered in the surgical decision.…”

Prevalence and Predisposing Factors for Recurrence after Hallux Valgus Surgery: A Systematic Review and Meta-Analysis

“…Follow-up duration ranged from 1.5 [27] to 124 months [28] (mean follow-up length = 42.7 months). Regarding the study location, eleven studies were conducted in Asian countries, including Korea [29][30][31], Japan [7,24,25], Singapore [27,32], China [33], Turkey [9] and Hong Kong [26], three in the USA [8,21,22] and six in European countries, including Finland [5], Austria [28,34], Germany and Switzerland [35], Greece [36] and the Netherlands [37]. In the remaining three studies, study location was not reported [23,38,39].…”

“…Surgical procedures varied across studies, including proximal metatarsal osteotomy [7,24,25], scarf osteotomy [9,27,28,32,35,36,38,39], chevron osteotomy [5,23], Ludloff osteotomy [29], syndesmosis procedure [26] or a combination thereof [8,21,22,31,33,34,37]. Recurrence rates ranged from 9% [31] to 73% [5].…”

“…Regarding the parameters used, studies reported data on IMA [5,8,9,21,23,[26][27][28]31,[34][35][36][37][38][39], HVA [8,23,25,[28][29][30][31]33,38,39], DMAA [30,31,38], sesamoid position [8,24,27,38], joint congruence [9,38], the shape of the lateral edge of the first metatarsal head [7] or the presence of a foot deformity [22,39] through radiographs. Other parameters were generalized ligamentous laxity [23], surgical procedure [29] and age [32].…”