Impact of pes planus on clinical outcomes of hallux valgus surgery

Tay, Adriel You Wei; Goh, Graham S.; Thever, Yogen; Yeo, Nicholas Eng Meng; Koo, Kevin

doi:10.1016/j.fas.2021.04.004

Cited by 4 publications

(6 citation statements)

References 37 publications

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“…Third, the cohort included patients who underwent additional minor procedures such as a Weil or Akin osteotomy, which may have introduced heterogeneity and confounded our results. However, both groups were propensity score matched for the presence of concomitant procedures, and it is not uncommon for concomitant foot procedures (in particular for lesser toe deformities) to be performed together with hallux valgus correction 37,43 ; hence, this inclusion may reflect prevailing clinical practice. Finally, we acknowledge the limitations of the satisfaction questionnaire as well as the AOFAS score used in this study.…”

Section: Discussionmentioning

confidence: 99%

Third-Generation Minimally Invasive Chevron-Akin Osteotomy for Hallux Valgus Produces Similar Clinical and Radiological Outcomes as Scarf-Akin Osteotomy at 2 Years: A Matched Cohort Study

et al. 2021

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Background: The minimally invasive chevron-Akin (MICA) osteotomy is an increasingly popular technique for the correction of hallux valgus. However, there is a paucity of literature comparing it with traditional open techniques. The purpose of this study was to compare the clinical and radiological outcomes of the MICA osteotomy using a new-generation MICA screw and scarf-Akin osteotomy for hallux valgus correction. Methods: Thirty cases of MICA osteotomy were propensity score matched 1:1 with a control group of 30 scarf-Akin osteotomy cases. The groups were matched for age, sex, body mass index, preoperative visual analog scale (VAS) score, American Orthopaedic Foot & Ankle Society (AOFAS) metatarsophalangeal-interphalangeal (MTP-IP) score, 36-Item Short-Form Health Survey (SF-36) physical component score (PCS) and mental component score (MCS), preoperative hallux valgus angle (HVA) and intermetatarsal angle (IMA), and concomitant procedures. Outcomes were compared at 6 and 24 months postoperatively. Early postoperative VAS scores were also compared. Results: Both groups demonstrated significant improvements in VAS score, AOFAS score, and SF-36 PCS and MCS at 6 and 24 months postoperatively. For the MICA group, HVA improved from 23.5 to 7.7 degrees, and IMA improved from 13.5 to 7.5 degrees. For the scarf-Akin osteotomy group, HVA improved from 23.7 to 9.3 degrees, and IMA improved from 13.6 to 7.8 degrees. The first 24-hour postoperative VAS score was significantly lower in the MICA group compared with the scarf-Akin group (2.0 ± 2.0 vs 3.4 ± 2.6, P = .029). However, there was no significant difference in clinical or radiological outcomes between the groups at 6 and 24 months. Conclusion: The MICA procedure with the new-generation MICA screw is an attractive option for the correction of hallux valgus, yielding similar midterm radiological and clinical outcomes compared with the well-established scarf-Akin osteotomy. The first 24-hour postoperative VAS score in the MICA group was also statistically lower, although its clinical significance remains to be determined. Level of Evidence: Level III, retrospective comparative study.

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Section: Discussionmentioning

confidence: 99%

Third-Generation Minimally Invasive Chevron-Akin Osteotomy for Hallux Valgus Produces Similar Clinical and Radiological Outcomes as Scarf-Akin Osteotomy at 2 Years: A Matched Cohort Study

et al. 2021

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“…Prior studies have explored the relationship between asymptomatic flatfoot, patient-reported outcomes, and bunion recurrence following various osteotomies. 3,7,26 Catani et al 3 found that their case series of 14 patients with hallux valgus and asymptomatic flatfoot undergoing percutaneous distal metatarsal osteotomy and exostectomy experienced significant improvement in American Orthopaedic Foot & Ankle Society (AOFAS) function and pain scores; however, these postoperative scores were lower than those reported in the literature for percutaneous bunionectomy. On the other hand, Tay et al 26 found that there were no associations between the degree of flatfoot deformity and pain VAS, AOFAS, or SF-36 scores in patients who underwent scarf osteotomy.…”

Section: Discussionmentioning

confidence: 98%

“…They also found no significant differences in postoperative radiographic outcomes between patients with and without flatfoot. 26 …”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…2,7,18 Prior studies have demonstrated that hallux valgus patients who also have an asymptomatic flatfoot have a higher recurrence rate but similar patient-reported outcomes when the hallux valgus is corrected with osteotomies. 7,26 Interestingly, the modified Lapidus procedure, which is the fusion of the first TMT joint, is a technique that is frequently used to correct both hallux valgus and flatfoot deformities. 5,22 The Lapidus procedure has been found to correct not only the forefoot deformity but also the hindfoot deformity (or 3D correction) in flatfoot deformity.…”

Section: Introductionmentioning

confidence: 99%

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Impact of Asymptomatic Flatfoot on Clinical and Radiographic Outcomes of the Modified Lapidus Procedure in Patients With Hallux Valgus

Rajan

Kim

Fuller

et al. 2022

Foot & Ankle Orthopaedics

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Background: Patients with hallux valgus commonly present with concomitant flatfoot deformity. First-ray hypermobility, among other biomechanical factors, has been suggested as a potential link between these deformities. However, not all hallux valgus patients exhibit symptoms associated with flatfoot deformity, and the necessity of correcting the asymptomatic flatfoot at the time of hallux valgus correction is unclear. We aimed to investigate the relationship between asymptomatic flatfoot and patient-reported and radiographic outcomes after the Lapidus procedure. Methods: This study included 142 patients who underwent the Lapidus procedure for hallux valgus at a single institution. Sixty-one patients met radiographic criteria for flatfoot. No patients exhibited symptoms related to flatfoot deformity on review of clinical notes. Preoperative, minimum 1-year postoperative, and change in Patient-Reported Outcomes Measurement Information System (PROMIS) scores between asymptomatic flatfoot and control groups were compared. Radiographic outcomes including hallux valgus angle (HVA), intermetatarsal angle (IMA), Meary angle, talonavicular coverage angle (TNCA), and calcaneal pitch (CP) were compared. Results: Preoperatively, the flatfoot group had higher BMI 22.6 vs 24.6 ( P < .01) and IMA 15.32 vs 14.0 degrees ( P < .05). Both groups demonstrated preoperative to postoperative improvement in PROMIS physical function ( P < .01), pain interference ( P < .001), pain intensity ( P < .001), and global physical health ( P < .001). There were no preoperative or postoperative differences in PROMIS scores between groups. Postoperatively, there were no differences in HVA or IMA between groups; however, the flatfoot group exhibited greater deformity in Meary angle, TNCA, and CP (all P < .001). Conclusion: There were no significant postoperative differences in patient-reported outcomes of the Lapidus procedure between patients with and without asymptomatic flatfoot, and both groups achieved similar radiographic correction of their hallux valgus deformity. The Lapidus procedure appears to be a reasonable surgical option for hallux valgus correction in patients with asymptomatic flatfoot deformity. Level of Evidence: Level III, retrospective cohort study.

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Correlation Between Traditional Anteroposterior Radiographic Measurements With Lateral Radiographic Measurements Following Triplanar Correction of Hallux Valgus and With Patient-Reported Outcomes From a Prospective Multicenter Trial

Archer,

Reine,

Ramachandran

et al. 2024

The Journal of Foot and Ankle Surgery

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Impact of pes planus on clinical outcomes of hallux valgus surgery

Cited by 4 publications

References 37 publications

Third-Generation Minimally Invasive Chevron-Akin Osteotomy for Hallux Valgus Produces Similar Clinical and Radiological Outcomes as Scarf-Akin Osteotomy at 2 Years: A Matched Cohort Study

Third-Generation Minimally Invasive Chevron-Akin Osteotomy for Hallux Valgus Produces Similar Clinical and Radiological Outcomes as Scarf-Akin Osteotomy at 2 Years: A Matched Cohort Study

Impact of Asymptomatic Flatfoot on Clinical and Radiographic Outcomes of the Modified Lapidus Procedure in Patients With Hallux Valgus

Correlation Between Traditional Anteroposterior Radiographic Measurements With Lateral Radiographic Measurements Following Triplanar Correction of Hallux Valgus and With Patient-Reported Outcomes From a Prospective Multicenter Trial

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