Is Generalized Ligamentous Laxity a Prognostic Factor for Recurred Hallux Valgus Deformity?

Abstract

Category: Bunion Introduction/Purpose: It is still unclear whether generalized ligamentous laxity is a risk factor for recurred hallux valgus deformity. This study was performed to evaluate the intermediate-term clinical outcomes after proximal chevron osteotomy for hallux valgus in patients with generalized ligamentous laxity, and to determine the effect on postoperative recurrence of deformity. Methods: A total of 198 feet from 169 female patients were treated with a proximal chevron osteotomy for hallux valgus with a mean follow-up of 46.3 months. When generalized ligamentous laxity was defined as Beighton score ≥ 5 points, there were 18 patients (10.7%) in laxity group and 151 patients (89.3%) in non-laxity group. Clinical evaluation consisted of the American Orthopaedic Foot and Ankle Society (AOFAS) scores, Foot and Ankle Ability Measure (FAAM), and radiographic measurement of hallux alignment. Risk factors associated with postoperative recurrence were evaluated using univariate analysis. Results: Recurrence rates were 21.7% in the laxity group and 17.1% in non-laxity group (p = 0.218), when defined as hallux valgus angle ≥ 20°. No significant differences of measurement at final follow-up were found between the 2 groups in terms of AOFAS score, FAAM, recurrence rate, hallux valgus angle (HVA), intermetatarsal angle (IMA) and distal metatarsal articular angle (DMAA). Preoperative HVA and IMA were found to be predictive factors of recurrence (OR = 6.3, 4.2; P = .001, .018, respectively). Conclusion: There were no statistical differences in the clinical and radiographic outcomes between hallux valgus with and without generalized ligamentous laxity. Generalized ligamentous laxity demonstrated no definitive effects on postoperative recurrence of hallux valgus deformity.