Effectiveness of hallux valgus surgery on patient quality of life: a systematic review and meta-analysis

Abstract

Background and purpose — The quality of life (QoL) of patients with hallux valgus (HV) usually improves postoperatively. Evidence regarding the effect of HV surgery on different domains of patient QoL remains inconclusive. This systematic review and meta-analysis estimates the effect of HV surgery on patient QoL through distinguishing effects on physical domains (comprising physical function and body pain domains) using the EuroQol-5D, short form (SF) health survey-12, and SF-36 QoL scales and a visual analogue scale (VAS) score and mental and social domains using QoL scales. Patients and methods — MEDLINE, EMBASE, Cochrane Library, and Web of Science databases were systematically searched from inception to March 2019 for studies on the effect of HV surgery on patient QoL. A standardized mean difference score was calculated for each specific QoL domain (mental, social, pain, physical, and VAS) using Cohen’s d index. The pooled effect size (ES) was estimated using a random-effects model based on the DerSimonian and Laird method. Results — From 12 published studies selected, the estimated pooled ES for QoL was 1.01 (95% confidence interval [CI] 0.52–1.51; I 2 = 87%) for body pain and 0.43 (CI 0.31–0.55, I 2 = 35%) for physical function. Regarding the composite mental and social domains of QoL, the pooled ES estimates were 0.24 (CI 0.00–0.47, I 2 = 80%) and 0.42 (CI 0.21–0.63, I 2 = 6.4%), respectively. The pooled difference in means for the VAS score was –4.1 (CI –4.5 to –3.6, I 2 = 90%). Interpretation — Our data showed that HV surgery decreased patients’ perceptions regarding pain. Furthermore, the data confirmed that HV surgery increased patients’ QoL, particularly concerning physical and social domains.

Effectiveness of hallux valgus surgery on improving health-related quality of life: A follow up study

“…55,56,57 Although most studies only reported data from the AOFAS and VAS scales, the use of PROMs 58 is encouraged to assess HV surgery outcomes. 59 Their inclusion could provide valuable information for the evaluation of patients' outcomes, 33 and could play an important role in determining the impact of HV surgery on HRQoL.…”

“…Although the AOFAS score cannot be considered a true patient-reported outcome measures (PROM) 29 , it is usually the most used tool in clinical studies of the foot and ankle. 30,31 Systematic reviews 32 have shown that HV surgery is a more effective procedure than conservative or no treatment in reducing pain 33 . However, high-quality studies comparing similar types of HV treatments and rates of complications or unfavorable outcomes re lacking.…”

Percutaneous Chevron and Akin (PECA) Osteotomies for Severe Hallux Valgus Deformity With Mean 3-Year Follow-up

“…Increased severity of hallux valgus is associated with increased age and linked with significant pain, negative impact on recreational activities, difficulty walking, and problems with footwear. 14,38,39 Severity of hallux valgus is typically based on radiographic assessment of weightbearing radiographs. Severe hallux valgus is defined as a hallux valgus angle (HVA) greater than 40 degrees and/or the 1-2 intermetatarsal angle (IMA) greater than 20 degrees.…”

Effectiveness of Hallux Valgus Surgery on Improving Health-related Quality of Life: A Follow Up Study

“…Although the AOFAS score cannot be considered a true patient-reported outcome measures (PROM) 29 , it is usually the most used tool in clinical studies of the foot and ankle. 30,31 Systematic reviews 32 have shown that HV surgery is a more effective procedure than conservative or no treatment in reducing pain 33 . However, high-quality studies comparing similar types of HV treatments and rates of complications or unfavorable outcomes re lacking.…”