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Incidence and Progression of Hallux Valgus: A Prospective Cohort Study
Hylton B Menz1, Michelle Marshall2, Martin J Thomas3
1La Trobe University, Melbourne, Victoria, Australia, and Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, Staffordshire, UK.
Insights
Hallux valgus incidence in adults over 50 is linked to age, poor health, foot pain, and narrow shoes. Progression affects one in three, suggesting joint changes can occur after age 50.
Area of Science:
- Orthopedics
- Podiatry
- Epidemiology
Background:
- Hallux valgus is a prevalent and debilitating foot condition.
- Understanding factors influencing its onset and worsening is crucial for public health.
Purpose of the Study:
- To investigate the incidence and progression of hallux valgus in adults aged 50 and older.
- To identify associated risk factors for hallux valgus development and advancement.
Main Methods:
- A population-based prospective cohort study (Clinical Assessment Study of the Foot) was conducted.
- 1,482 participants aged 50+ completed baseline and 7-year follow-up surveys including health questionnaires and hallux valgus self-assessment.
- Data analysis identified incident cases and progression of hallux valgus.
Main Results:
- Hallux valgus incidence was 20.1% over 7 years, associated with older age, poorer physical health, foot pain, and narrow toe-box footwear in younger adulthood.
- Hallux valgus progression was observed in 33.6% of participants.
- No baseline factors were associated with hallux valgus progression.
Conclusions:
- Approximately 1 in 5 adults aged 50+ develop hallux valgus over 7 years, influenced by age, health, pain, and prior footwear choices.
- Hallux valgus progression affects 1 in 3 adults in this age group.
- First metatarsophalangeal joint alignment can change beyond age 50, indicating ongoing disease processes.
Objective:
Hallux valgus is a common and disabling condition. The objective of the present study was to identify factors associated with hallux valgus incidence and progression.
Methods:
Participants were from a population-based prospective cohort study, the Clinical Assessment Study of the Foot. All adults ages ≥50 years who were registered at 4 general practices in North Staffordshire, UK, were invited to take part in a postal survey at baseline and at 7-year follow-up, which included health questionnaires and self-assessment of hallux valgus using line drawings.
Results:
Complete baseline and follow-up data were available for 1,482 participants (739 women and 743 men, mean ± SD age 62.9 ± 8.1 years), of whom 450 (30.4%) had hallux valgus in at least 1 foot at baseline. Incident hallux valgus was identified in 207 (20.1%) participants (349 [15.4%] feet) and was associated with baseline age, poorer physical health, foot pain, and wearing shoes with a very narrow toe-box shape between the ages of 20 and 29 years. Hallux valgus progression was identified in 497 (33.6%) participants (719 [24.3%] feet) but was not associated with any baseline factors.
Conclusion:
Incident hallux valgus develops in 1 in 5 adults ages ≥50 years over a 7-year period and is related to age, poorer physical health, foot pain, and previous use of constrictive footwear. Progression occurs in 1 in 3 adults. These findings suggest that changes in first metatarsophalangeal joint alignment may still occur beyond the age of 50 years.
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