Advanced Age, Severe Deformity and Diminished Expectations: Functional and Radiological Outcomes of Different Osteotomies for Hallux Valgus in The Elderly
Öz
Background: Although advanced age is often linked to reduced bone quality in hallux valgus (HV), its direct impact on surgical outcomes is unclear. This study aimed to compare the functional and radiological outcomes of HV surgeries between patients aged ≥65 and <65 years.
Methods: A retrospective analysis of 102 patients who underwent HV surgery between 2011 and 2024 was conducted. Surgical methods included distal and proximal osteotomies and Lapidus arthrodesis. Functional outcomes were assessed using the visual analog scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) Hallux Metatarsophalangeal- Interphalangeal Rating System score. Radiographic outcomes were evaluated using preoperative and postoperative measurements of the hallux valgus angle (HVA) and the intermetatarsal angle (IMA).
Results: Among the 102 patients, 87 were under 65 years of age (85.3%) and 15 were older (14.7%). No significant differences were found between the age groups in terms of AOFAS scores (p=0.916), VAS scores (p=0.481), or radiographic parameters (p>0.05). However, surgical technique significantly affected outcomes; arthrodesis resulted in greater angular correction and lower VAS scores than distal osteotomies (p<0.05). Proximal osteotomies showed better correction than distal procedures, but without significant differences in functional scores (p>0.05).
Conclusions: Age does not significantly affect functional and radiological outcomes in HV surgery. The likelihood of surgical success depends on the technique used rather than the patient’s age. The utilization of individualized treatment plans tailored to the severity of the deformity has been demonstrated to yield superior outcomes, irrespective of the patient's age.
Anahtar Kelimeler
Hallux valgus, proximal osteotomy, distal osteotomy, arthrodesis, elderly
Destekleyen Kurum
The authors declared that this study has received no financial support.
Etik Beyan
This study was reviewed and approved by the Marmara University Faculty
of Medicine, Non-Pharmaceuticals and Non-Medical Devices Research
Ethics Committee (Protocol No: 09.2024.1588, Date: 24.12.2024). Informed consent was obtained from all individual participants included in the study.
Teşekkür
The authors declare that they have no acknowledgements to report.
Kaynakça
- Menz HB, Roddy E, Thomas E, Croft PR. Impact of hallux valgus severity on general and foot-specific health-related quality of life. Arthritis Care Res (Hoboken). 2011;63(3):396-404.
- Cho NH, Kim S, Kwon DJ, Kim HA. The prevalence of hallux valgus and its association with foot pain and function in a rural Korean community. J Bone Joint Surg Br. 2009;91(4):494-8.
- Golightly YM, Hannan MT, Dufour AB, Renner JB, Jordan JM. Factors associated with hallux valgus in a community-based cross-sectional study of adults with and without osteoarthritis. Arthritis Care Res (Hoboken). 2015;67(6):791-8.
- Coughlin MJ. Roger A. Mann Award. Juvenile hallux valgus: etiology and treatment. Foot Ankle Int. 1995;16(11):682-97.
- Robinson AH, Limbers JP. Modern concepts in the treatment of hallux valgus. J Bone Joint Surg Br. 2005;87(8):1038-45.
- Zirngibl B, Grifka J, Baier C, Götz J. Hallux valgus: Ätiologie, diagnostische und therapeutische Prinzipien. Orthopade. 2017;46(3):283-96.
- Ray JJ, Friedmann AJ, Hanselman AE, Vaida J, Dayton PD, Hatch DJ, Smith B, Santrock RD. Hallux Valgus. Foot Ankle Orthop. 2019;4(2):2473011419838500.
- Fraissler L, Konrads C, Hoberg M, Rudert M, Walcher M. Treatment of hallux valgus deformity. EFORT Open Rev. 2016;1(8):295-302.
- Jeyaseelan L, Malagelada F. Minimally Invasive Hallux Valgus Surgery—A Systematic Review and Assessment of State of the Art. Foot Ankle Clin. 2020;25(3):345-59.
- Muehleman C, Bareither D, Huch K, Cole AA, Kuettner KE. Prevalence of degenerative morphological changes in the joints of the lower extremity. Osteoarthr Cartil. 1997;5(1):23‑37.