Patient-Reported Outcomes Before and After Hallux Valgus Surgery: 2-Year Results From a National Registry Study

Hallux valgus (HV) is a common condition associated with pain, functional limitations, and reduced health-related quality of life. Population-level data on 2-year results of surgical treatment remain limited. The aim of this study was to evaluate patient-reported outcome measures (PROMs) before surgery, and 1- and 2-year follow-up in patients registered in the Swedish quality registry for foot and ankle surgery ("Swefoot") who underwent surgery for HV. Further, the relation between PROMs and HV severity, BMI, and smoking habits was explored.

Seven hundred sixty-five feet from 742 patients (median age 58, 87% women) who underwent primary surgery for HV were included. Data on demographics, comorbidities, HV severity, surgical procedures, and PROMs were extracted. PROMs included the Self-Reported Foot and Ankle score (SEFAS), EuroQol 5-dimensional, 3-level (EQ-5D), and satisfaction regarding surgery, appearance, shoe wear, and pain.

At both 1- and 2-year follow-ups, approximately 80% of responding patients reported satisfaction with the surgical outcome (80.4% and 81.0%, respectively). Patients reported significant improvements in SEFAS scores: mean increase of 10 points (95% CI 9.1-10.4) at 1 year and 11 points (95% CI 9.8-11.2) at 2 years compared to baseline. Health-related quality of life also improved significantly; EQ-5D VAS was improved with 7 (95% CI 5-8) after 1 year and EQ-5D index was improved with 0.19 (95% CI 0.17-0.21). The EQ-5D VAS and index did not change significantly between the 1- and 2-year follow-ups.Significant improvements were also reported in satisfaction with appearance, shoe wear, and pain. Regardless of HV grade, the patients had similar improvement in SEFAS. Overweight/obese patients experienced similar improvements as underweight/normal BMI ones. Smokers showed significantly less improvement in SEFAS.

This population-based study using the Swefoot registry data demonstrates that patients surgically treated for HV reported significant improvements in PROMs from before surgery to 1 and 2 years after surgery.

Level II, prognostic study.