Improved Function after Hallux Valgus Surgery

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Joanne Swanson
Cindy Oertel, 847 384-4139
Lisa Doty, [email protected]

Study reports improved function after hallux valgus surgery

ORLANDO, Fla.--A multi-center outcomes study presented here today found pain, function, shoe comfort and patient satisfaction are significantly improved after hallux valgus surgery to correct bunions, a bony prominence on the big (or great) toe.

Research reported at the 67th annual meeting of the American Academy of Orthopaedic Surgeons evaluated the effects of hallux valgus surgery on the lives of patients by using a validated outcomes survey instrument. This is the first outcomes study on bunions to use the MODEMS survey tool, reported study author David B. Thordarson, MD, associate professor, and chief of foot and ankle reconstructive surgery, department of orthopaedics, University of Southern California, Los Angeles.

The Musculoskeletal Outcomes Data Evaluation and Management System (MODEMS) program enables physicians to collect data that can be stored as part of a national databank so that researchers can compare their practices to national norms.

"We now have evidence to show patients that they can expect less pain and improved function within six months following bunion surgery," Dr. Thordarson explained. "In addition, our results found the ability to wear shoes comfortably returns quickly when compared to patient's preoperative levels of comfort."

Orthopaedic researchers enrolled 305 patients in the study upon completion of a baseline MODEMS questionnaire. Patients in the study were eighteen years of age or older and experienced pain unresponsive to conservative treatment shoe modification; a bony prominence on the big toe with a hallux valgus greater than 20 degrees; and did not have inflammatory arthritis.

Dr. Thordarson reported a five-point improvement, based upon the MODEMS rating scale, in many of the patients. Six months following surgery, 179 patients who completed the questionnaires indicated function had increased and their ability to now comfortably wear shoes had improved.

While these result are preliminary, Dr. Thordarson reported, further evaluation will include multiple comparisons of outcomes scores between the three different types of surgery commonly performed to relieve hallux valgus pain--chevron, basilar metatarsal osteotomy and TMT fusion.

Chevron surgery commonly is used to correct less severe deformities. Basilar metatarsal osteotomy changes the alignment of the bones of the foot and allows for greater correction, and TMT fusion permanently unites two bony segments of the foot.

The big (or great) toe rotates so that the toe is pointing away from the second toe is characteristic of hallux valgus (bunion). "Bunions cause patient discomfort ranging from sharp pain to an inability to wear certain types of shoes," Dr. Thordarson said. "Our results prove the positive outcomes that this procedure can have for patients in leading a pain-free life."

The study was supported by the American Orthopaedic Foot and Ankle Society, Orthopaedic Research and Education Foundation and the department of orthopaedics, University of Southern California, Los Angeles.

An orthopaedic surgeon is a medical doctor with extensive training in the diagnosis and nonsurgical as well as surgical treatment of the musculoskeletal system, including bones, joints, ligaments, tendons, muscles, and nerves.

The 24,500-member American Academy of Orthopaedic Surgeons (www.aaos.org) is a not-for-profit organization that provides education programs for orthopaedic surgeons, allied health professionals and the public, and is an advocate for improved patient care.

In the first year of the United Nations-declared Bone and Joint Decade (2000-2010) (http://www.boneandjointdecade.org), the Academy is holding its annual meeting at the Orange County Convention Center, Orlando, March 15-19.

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