Effectiveness of hallux valgus surgery on improving health-related quality of life: A follow up study

Abstract

BackgroundHallus valgus (HV) negatively impacts health-related quality of life (HRQoL). Patient-reported outcome measures (PROMs) are increasingly used in clinical studies of the foot and ankle. We aimed to evaluate the effect of HV surgery on PROMs (i.e., pain scales, general HRQoL, and region-speci c scales) and radiological angles. Additionally, we aimed to determine whether the effect on these outcomes depends on the type of surgery (including open and percutaneous techniques) and if it is in uenced by potential confounding factors (i.e., age, HVA, 1-2 IMA, body mass index (BMI), and distal metatarsal articular angle (DMAA). MethodsThis was a longitudinal prospective study. We collected the clinical data of all patients who underwent surgery for symptomatic HV deformity in the orthopedic department of the Virgen de la Luz Hospital of Cuenca (Spain).The clinical outcomes were assessed using the American Orthopedic Foot and Ankle Society (AOFAS) Hallux metatarsophalangealinterphalangeal (HMI) scale, visual analogue scale (VAS), Manchester Oxford foot questionnaire (MOXFQ), short form health survey (SF-12) and European Quality of Life-5 Dimensions (EQ-5D). ResultsA total of 72 patients (70 women, 97.2%) were included in the study 72 (72 feet).The AOFAS pre-post-surgery score changed from 42.16

Pre- and Post-Operative Relationship between Radiological Measures and Clinical Outcomes in Women with Hallux Valgus

“…It consists of 16 questions with a score out of 100 for three separate domains, although the three domain scores can be summarized into a single index score [35]. Similarly to our results, other authors have also reported significant improvements in MOXFQ scores after HV surgery [30].…”

“…The first point to be highlighted in this work is the fact that the HVA and IMA values, the variables most frequently used to quantify HV deformities, significantly improved from before the operation to the follow-up. This has also been frequently reported with the use of different surgical techniques [3,7,15,19,22,[29][30][31]. In our work, two of the parameters used to assess the sesamoid position, namely, the DFS and TMH, also significatively improved from the pre-to the postoperative assessment.…”

“…This scale, with a 0-100 score, is the most frequently used functional outcome tool [27]. Other authors have also reported significant improvements in AOFAS scores after HV surgery using different techniques [3,11,19,22,[29][30][31]33]. Our patients also showed a significant improvement in PROMs from the preoperative period to the follow-up, assessed through the MOXFQ.…”

“…Similarly, several authors have found that quality of life is decreased in patients with HV in comparison with a "normal" population, but the MOXFQ score showed no correlation with the radiological parameters [26,38]. Others have also observed that there is no correlation between radiological results and MOXFQ score after surgery [30]. Our results show that there is no significant relationship between the AOFAS and MOXFQ scoring with the HVA and IMA values both pre and postoperatively.…”

What’s New in Foot and Ankle Surgery

“…Further data continue to demonstrate short-term equivalency but not superiority for minimally invasive hallux valgus surgery compared with open techniques. Hernández-Castillejo et al 4 performed a longitudinal, prospective study on 72 patients (72 feet) who underwent open chevron, open scarf, or percutaneous Reverdin-Isham osteotomy for the correction of hallux valgus deformity. At a mean follow-up of 17.7 months, all patient-reported outcome measures, including the VAS pain score and Manchester Oxford Foot Questionnaire (MOXFQ), demonstrated significant improvement independent of the preoperative radiographic parameters and type of surgical procedure.…”