Predictors of Patient Satisfaction in Hallux Valgus Surgery

This study aims to analyze a combination of preoperative biodata, radiological parameters, and validated functional scores to determine predictors for patient satisfaction in patients who have undergone Hallux abducto valgus (HAV) surgery at 2 years postoperatively. Data from 288 patients who had undergone HAV surgery and 373 cases were collected between 2007 and 2013. The study group measured the HAV angle (HVA), tibial sesamoid position (TSP), as well as inter-metatarsal angle (IMA) on both pre- and postoperative radiographs for all patients. Clinical outcomes such as the Visual Analogue Scale for pain, the American Orthopaedic Foot and Ankle Society (AOFAS) Hallux Metatarsophalangeal-Interphalangeal Scale (MTP-ITP) Scale, and Short Form 36 Health Survey's physical and mental component scores (PCS and MCS) were captured preoperatively and postoperatively. Univariate analysis was performed first to determine possible predictors of patient satisfaction and the results were then included in a binary logistic regression model. Independent predictors of patient satisfaction include higher preoperative AOFAS (p value = .028, 95% confidence interval [CI] 0.958, 0.998) and the 2 years postoperative AOFAS (p = .001, 95% CI 1.027, 1.114). We also found PCS and MCS scores at 2 years postoperatively to be independent predictors of patient satisfaction (p = .004, 95% CI 1.015, 1.086 and p = .045, 95% CI 1.001, 1.064 respectively). Predictors of patient satisfaction include subjective outcomes such as the AOFAS score and the Short Form 36 composite quality of life scales of PCS and MCS, rather than objective radiological outcomes such as HVA, IMA, and TSP.