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Factors Associated With Early Loss of Hallux Valgus Correction

Published:December 15, 2017DOI:https://doi.org/10.1053/j.jfas.2017.08.018

      Abstract

      Recurrence is common after hallux valgus corrective surgery. Although many investigators have studied the risk factors associated with a suboptimal hallux position at the end of long-term follow-up, few have evaluated the factors associated with actual early loss of correction. We conducted a retrospective cohort study to identify the predictors of lateral deviation of the hallux during the postoperative period. We evaluated the demographic data, preoperative severity of the hallux valgus, other angular measurements characterizing underlying deformities, amount of hallux valgus correction, and postoperative alignment of the corrected hallux valgus for associations with recurrence. After adjusting for the covariates, the only factor associated with recurrence was the postoperative tibial sesamoid position. The recurrence rate was ~50% and ~60% when the postoperative tibial sesamoid position was >4 and >5 on the 7-point scale, respectively.

      Level of Clinical Evidence

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      References

        • Pentikainen I.
        • Ojala R.
        • Ohtonen P.
        • Piippo J.
        • Leppilahti J.
        Preoperative radiological factors correlated to long-term recurrence of hallux valgus following distal chevron osteotomy.
        Foot Ankle Int. 2014; 35: 1262-1267
        • Raikin S.M.
        • Miller A.G.
        • Daniel J.
        Recurrence of hallux valgus: a review.
        Foot Ankle Clin. 2014; 19: 259-274
        • Okuda R.
        • Kinoshita M.
        • Yasuda T.
        • Jotoku T.
        • Shima H.
        • Takamura M.
        Hallux valgus angle as a predictor of recurrence following proximal metatarsal osteotomy.
        J Orthop Sci. 2011; 16: 760-764
        • Choi G.W.
        • Choi W.J.
        • Yoon H.S.
        • Lee J.W.
        Additional surgical factors affecting the recurrence of hallux valgus after Ludloff osteotomy.
        Bone Joint J. 2013; 95-B: 803-808
        • Aiyer A.
        • Shub J.
        • Shariff R.
        • Ying L.
        • Myerson M.
        Radiographic recurrence of deformity after hallux valgus surgery in patients with metatarsus adductus.
        Foot Ankle Int. 2016; 37: 165-171
        • Deveci A.
        • Firat A.
        • Yilmaz S.
        • Oken O.F.
        • Yildirim A.O.
        • Ucaner A.
        • Bozkurt M.
        Short-term clinical and radiologic results of the scarf osteotomy: what factors contribute to recurrence?.
        J Foot Ankle Surg. 2013; 52: 771-775
        • Iyer S.
        • Demetracopoulos C.A.
        • Sofka C.M.
        • Ellis S.J.
        High rate of recurrence following proximal medial opening wedge osteotomy for correction of moderate hallux valgus.
        Foot Ankle Int. 2015; 36: 756-763
        • Park C.H.
        • Ahn J.Y.
        • Kim Y.M.
        • Lee W.C.
        Plate fixation for proximal chevron osteotomy has greater risk for hallux valgus recurrence than Kirschner wire fixation.
        Int Orthop. 2013; 37: 1085-1092
        • Choi G.W.
        • Kim H.J.
        • Kim T.S.
        • Chun S.K.
        • Kim T.W.
        • Lee Y.I.
        • Kim K.H.
        Comparison of the modified McBride procedure and the distal chevron osteotomy for mild to moderate hallux valgus.
        J Foot Ankle Surg. 2016; 55: 808-811
        • Shi G.G.
        • Henning P.
        • Marks R.M.
        Correlation of postoperative position of the sesamoids after chevron osteotomy with outcome.
        Foot Ankle Int. 2016; 37: 274-280
        • Shibuya N.
        • Thorud J.C.
        • Martin L.R.
        • Plemmons B.S.
        • Jupiter D.C.
        Evaluation of hallux valgus correction with versus without akin proximal phalanx osteotomy.
        J Foot Ankle Surg. 2016; 55: 910-914
        • Lee K.M.
        • Ahn S.
        • Chung C.Y.
        • Sung K.H.
        • Park M.S.
        Reliability and relationship of radiographic measurements in hallux valgus.
        Clin Orthop Relat Res. 2012; 470: 2613-2621
        • Shibuya N.
        • Jupiter D.C.
        • Plemmons B.S.
        • Martin L.
        • Thorud J.C.
        Correction of hallux valgus deformity in association with underlying metatarsus adductus deformity.
        Foot Ankle Spec. 2017; (Feb 1; Epub ahead of print)https://doi.org/10.1177/1938640017690441
        • Coughlin M.J.
        • Saltzman C.L.
        • Nunley 2nd., J.A.
        Angular measurements in the evaluation of hallux valgus deformities: a report of the ad hoc committee of the American Orthopaedic Foot & Ankle Society on angular measurements.
        Foot Ankle Int. 2002; 23: 68-74
        • Srivastava S.
        • Chockalingam N.
        • El Fakhri T.
        Radiographic measurements of hallux angles: a review of current techniques.
        Foot (Edinb). 2010; 20: 27-31
        • Hardy R.H.
        • Clapham J.C.
        Observations on hallux valgus; based on a controlled series.
        J Bone Joint Surg Br. 1951; 33-B: 376-391
        • Schneider W.
        • Csepan R.
        • Knahr K.
        Reproducibility of the radiographic metatarsophalangeal angle in hallux surgery.
        J Bone Joint Surg Am. 2003; 85-A: 494-499
        • Coughlin M.J.
        Hallux valgus.
        J Bone Joint Surg Am. 1996; 78: 932-966
        • Vanore J.V.
        • Christensen J.C.
        • Kravitz S.R.
        • Schuberth J.M.
        • Thomas J.L.
        • Weil L.S.
        • Zlotoff H.J.
        • Mendicino R.W.
        • Couture S.D.
        • Clinical Practice Guideline First Metatarsophalangeal Joint Disorders Panel of the American College of Foot and Ankle Surgeons
        Diagnosis and treatment of first metatarsophalangeal joint disorders. Section 1: hallux valgus.
        J Foot Ankle Surg. 2003; 42: 112-123
        • Lamm B.M.
        • Stasko P.A.
        • Gesheff M.G.
        • Bhave A.
        Normal foot and ankle radiographic angles, measurements, and reference points.
        J Foot Ankle Surg. 2016; 55: 991-998
        • Kilmartin T.E.
        • Barrington R.L.
        • Wallace W.A.
        Metatarsus primus varus: a statistical study.
        J Bone Joint Surg Br. 1991; 73: 937-940
        • Lee W.C.
        • Kim Y.M.
        Correction of hallux valgus using lateral soft-tissue release and proximal chevron osteotomy through a medial incision.
        J Bone Joint Surg Am. 2007; 89: 82-89
        • Okuda R.
        • Kinoshita M.
        • Yasuda T.
        • Jotoku T.
        • Kitano N.
        • Shima H.
        Postoperative incomplete reduction of the sesamoids as a risk factor for recurrence of hallux valgus.
        J Bone Joint Surg Am. 2009; 91: 1637-1645
        • Okuda R.
        • Kinoshita M.
        • Morikawa J.
        • Jotoku T.
        • Abe M.
        Distal soft tissue procedure and proximal metatarsal osteotomy in hallux valgus.
        Clin Orthop Relat Res. 2000; 379: 209-217
        • Veri J.P.
        • Pirani S.P.
        • Claridge R.
        Crescentic proximal metatarsal osteotomy for moderate to severe hallux valgus: a mean 12.2 year follow-up study.
        Foot Ankle Int. 2001; 22: 817-822
        • Granberry W.M.
        • Hickey C.H.
        Hallux valgus correction with metatarsal osteotomy: effect of a lateral distal soft tissue procedure.
        Foot Ankle Int. 1995; 16: 132-138
        • Potenza V.
        • Caterini R.
        • Farsetti P.
        • Forconi F.
        • Savarese E.
        • Nicoletti S.
        • Ippolito E.
        Chevron osteotomy with lateral release and adductor tenotomy for hallux valgus.
        Foot Ankle Int. 2009; 30: 512-516
        • Woo K.
        • Yu I.S.
        • Kim J.H.
        • Sung K.S.
        Effect of lateral soft tissue release on sesamoid position in hallux valgus surgery.
        Foot Ankle Int. 2015; 36: 1463-1468
        • Lamo-Espinosa J.M.
        • Florez B.
        • Villas C.
        • Pons-Villanueva J.
        • Bondia J.M.
        • Aquerreta J.D.
        • Alfonso M.
        The relationship between the sesamoid complex and the first metatarsal after hallux valgus surgery without lateral soft-tissue release: a prospective study.
        J Foot Ankle Surg. 2015; 54: 1111-1115
        • Dayton P.
        • Feilmeier M.
        • Kauwe M.
        • Holmes C.
        • McArdle A.
        • Coleman N.
        Observed changes in radiographic measurements of the first ray after frontal and transverse plane rotation of the hallux: does the hallux drive the metatarsal in a bunion deformity?.
        J Foot Ankle Surg. 2014; 53: 584-587
        • DiDomenico L.A.
        • Fahim R.
        • Rollandini J.
        • Thomas Z.M.
        Correction of frontal plane rotation of sesamoid apparatus during the Lapidus procedure: a novel approach.
        J Foot Ankle Surg. 2014; 53: 248-251
        • Huang E.H.
        • Charlton T.P.
        • Ajayi S.
        • Thordarson D.B.
        Effect of various hallux valgus reconstruction on sesamoid location: a radiographic study.
        Foot Ankle Int. 2013; 34: 99-103
        • Kim Y.
        • Kim J.S.
        • Young K.W.
        • Naraghi R.
        • Cho H.K.
        • Lee S.Y.
        A new measure of tibial sesamoid position in hallux valgus in relation to the coronal rotation of the first metatarsal in CT scans.
        Foot Ankle Int. 2015; 36: 944-952
        • Jastifer J.R.
        • Coughlin M.J.
        • Schutt S.
        • Hirose C.
        • Kennedy M.
        • Grebing B.
        • Smith B.
        • Cooper T.
        • Golano P.
        • Viladot R.
        • Doty J.F.
        Comparison of radiographic and anatomic distal metatarsal articular angle in cadaver feet.
        Foot Ankle Int. 2014; 35: 389-393
        • Jeuken R.M.
        • Schotanus M.G.
        • Kort N.P.
        • Deenik A.
        • Jong B.
        • Hendrickx R.P.
        Long-term follow-up of a randomized controlled trial comparing scarf to chevron osteotomy in hallux valgus correction.
        Foot Ankle Int. 2016; 37: 687-695
        • Doty J.F.
        • Coughlin M.J.
        • Schutt S.
        • Hirose C.
        • Kennedy M.
        • Grebing B.
        • Smith B.
        • Cooper T.
        • Golano P.
        • Viladot R.
        • Remington R.
        Articular chondral damage of the first metatarsal head and sesamoids: analysis of cadaver hallux valgus.
        Foot Ankle Int. 2013; 34: 1090-1096
        • Roukis T.S.
        • Weil L.S.
        • Weil L.S.
        • Landsman A.S.
        Predicting articular erosion in hallux valgus: clinical, radiographic, and intraoperative analysis.
        J Foot Ankle Surg. 2005; 44: 13-21