Current Concepts Review: Hallux Valgus Part II: Operative Treatment

Outcome Studies for Hallux Valgus Results of most hallux valgus corrective procedures typically focus on the physicians’ perceptions rather than the patients’ perceptions of outcome.113 Thordarson et al.113 noted that patients’ perceptions of outcome generally are reduced to satisfied, satisfied with reservations, or dissatisfied. Although the American Orthopaedic Foot and Ankle Society (AOFAS) rating system aims to standardize outcomes data collection,55 it remains a physician-driven tool. Furthermore, its validity has been questioned in the evaluation of the hindfoot,118 a shortcoming that may also manifest in the forefoot.9 This is not a shortcoming isolated to the AOFAS rating system. In a recent meta-analysis of outcomes scales in foot and ankle surgery, Button and Pinney12 concluded that none of the 49 rating scales identified proved to be reliable, valid, or responsive in patients with foot and ankle conditions. The effort by a team of AOFAS members to create such an outcomes tool suggests that the AOFAS clinical rating system lacks adequate assessment of quality of life measures.114 Recently, SooHoo et al.110 demonstrated increased responsiveness of foot and ankle specific outcomes tools compared to the SF-36. However, the level of responsiveness for the bodily pain subscale and the physical component summary approached that of the AOFAS outcomes