The Journal of Bone and Joint Surgery (American). 2005;87:66-75.
doi:10.2106/JBJS.B.00288
© 2005 The Journal of Bone and Joint Surgery, Inc.
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Age-Adjusted Baseline Data for Women with Hallux Valgus Undergoing Corrective Surgery

David B. Thordarson, MD1, Edward Ebramzadeh, PhD2, Sally A. Rudicel, MD3 and Aaron Baxter, MD1

1 Department of Orthopaedic Surgery, University of Southern California, 1200 North State Street, GNH 3900, Los Angeles, CA 90033. E-mail address for D.B. Thordarson: thordars{at}usc.edu
2 Orthopaedic Hospital/JVL Research Center, 2400 South Flower Street, Los Angeles, CA 90007. E-mail address: eebramzadeh{at}laoh.ucla.edu
3 New England Medical Center, 750 Washington Street, Box 306, Boston, MA 02111-1526. E-mail address: srudicel{at}tufts-nemc.org

Investigation performed at the Department of Orthopaedic Surgery, University of Southern California, Los Angeles; Orthopaedic Hospital/JVL Research Center, Los Angeles, California; and New England Medical Center, Boston, Massachusetts

The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

Background: Functional and health-related quality-of-life data on a population of patients with hallux valgus are lacking. Similarly, the correlation of the severity of the deformity with these measures is unknown.

Methods: Two hundred and eighty-five women with an average age of forty-nine years who were scheduled for bunion surgery were enrolled in the study. The patients completed a baseline American Academy of Orthopaedic Surgeons (AAOS) foot and ankle outcomes questionnaire, which includes the Short Form-36 (SF-36) and a specific lower-extremity section on the foot and ankle. Preoperative radiographic data with regard to the hallux valgus angle and the intermetatarsal angle were stratified into groups according to the severity of the deformity (mild, moderate, or severe). The data were then stratified into age-groups consistent with those reported for the SF-36, and the results were compared with the SF-36 scores for the general population. The global foot and ankle score and the shoe comfort score were compared with general population scores that were published previously. The severity of the preoperative deformity was correlated with the baseline scores.

Results: General health scores were noted to be relatively stable throughout the age-groups for patients with bunions, with the older groups demonstrating better scores than the general population. Bodily pain scores were consistently worse for patients with a bunion through all age-groups compared with the general population. The average global foot and ankle score and the shoe comfort score were significantly lower (p < 0.001 for both) for the patients with a bunion than for the general population. The severity of the preoperative deformity did not correlate with any of the outcome scores.

Conclusions: The bodily pain score from the SF-36 appears to be a sensitive measure of problems experienced by patients undergoing bunion surgery. Surprisingly, the severity of the deformity as measured radiographically did not correlate with any of the fifteen scores measured. These data may serve as a baseline for clinical hallux valgus studies with use of the SF-36 or the AAOS outcomes questionnaire.


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