Daniel J Hatch, Avneesh Chhabra, Mindi Dayton, Paul D Dayton, Daniel C Farber, Deidre A Kile, Jennifer Koay, George T Liu, Jody P McAleer, Robert D Santrock
{"title":"Four-year outcomes following triplanar tarsometatarsal arthrodesis with early weightbearing for Hallux Valgus: A multicenter prospective study.","authors":"Daniel J Hatch, Avneesh Chhabra, Mindi Dayton, Paul D Dayton, Daniel C Farber, Deidre A Kile, Jennifer Koay, George T Liu, Jody P McAleer, Robert D Santrock","doi":"10.1053/j.jfas.2025.07.007","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Traditional hallux valgus surgery has been focused on two-dimensional repair with high reported recurrence rates.</p><p><strong>Purpose: </strong>We report the 4-year interim analysis of a prospective, 5-year, multicenter study of radiographic, clinical, and patient-reported outcomes following triplanar first tarsometatarsal arthrodesis with early weightbearing.</p><p><strong>Study design: </strong>This is a prospective, multicenter, clinical trial involving 7 US-based centers and 13 surgeons. One-hundred and seventy-three patients were treated, of whom 139 (80.3%) achieved their 48-month visit. Clinical and radiographic parameters were evaluated at all follow-up visits along with patient-reported outcomes [Visual Analog Scale (VAS), Manchester-Oxford Foot Questionnaire (MOxFQ) and Patient-Reported Outcomes Measurement Information System (PROMIS).</p><p><strong>Methods: </strong>Institutional review board approval was obtained for each study site. A consecutive cohort of patients were enrolled from November 2018 to April 2021 who received first TMT arthrodesis to correct their symptomatic hallux valgus. Inclusion and exclusion criteria were established.</p><p><strong>Results: </strong>Significant improvements in triplanar radiographic correction (hallux valgus angle, intermetatarsal angle, tibial sesamoid position, sagittal-plane IMA, and osseous foot width) were maintained at all timepoints. Using recurrence definitions of > 15° and 20° postoperative hallux valgus angle, recurrence rates were 8.4% (95% CI:4.27%, 14.53%) and 0.8% (95% CI:0.02%, 4.18%) at 48 months, respectively. Mean (95% CI) time to weightbearing in a boot walker was 7.7 (6.6, 8.8) days.</p><p><strong>Conclusion: </strong>The 4-year interim results of this prospective, multicenter study demonstrate favorable improvement of the triplanar hallux valgus deformity, maintenance of correction, low complication rate, and favorable patient-reported outcomes with early return to protected weightbearing.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3000,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Foot & Ankle Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1053/j.jfas.2025.07.007","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Traditional hallux valgus surgery has been focused on two-dimensional repair with high reported recurrence rates.
Purpose: We report the 4-year interim analysis of a prospective, 5-year, multicenter study of radiographic, clinical, and patient-reported outcomes following triplanar first tarsometatarsal arthrodesis with early weightbearing.
Study design: This is a prospective, multicenter, clinical trial involving 7 US-based centers and 13 surgeons. One-hundred and seventy-three patients were treated, of whom 139 (80.3%) achieved their 48-month visit. Clinical and radiographic parameters were evaluated at all follow-up visits along with patient-reported outcomes [Visual Analog Scale (VAS), Manchester-Oxford Foot Questionnaire (MOxFQ) and Patient-Reported Outcomes Measurement Information System (PROMIS).
Methods: Institutional review board approval was obtained for each study site. A consecutive cohort of patients were enrolled from November 2018 to April 2021 who received first TMT arthrodesis to correct their symptomatic hallux valgus. Inclusion and exclusion criteria were established.
Results: Significant improvements in triplanar radiographic correction (hallux valgus angle, intermetatarsal angle, tibial sesamoid position, sagittal-plane IMA, and osseous foot width) were maintained at all timepoints. Using recurrence definitions of > 15° and 20° postoperative hallux valgus angle, recurrence rates were 8.4% (95% CI:4.27%, 14.53%) and 0.8% (95% CI:0.02%, 4.18%) at 48 months, respectively. Mean (95% CI) time to weightbearing in a boot walker was 7.7 (6.6, 8.8) days.
Conclusion: The 4-year interim results of this prospective, multicenter study demonstrate favorable improvement of the triplanar hallux valgus deformity, maintenance of correction, low complication rate, and favorable patient-reported outcomes with early return to protected weightbearing.
期刊介绍:
The Journal of Foot & Ankle Surgery is the leading source for original, clinically-focused articles on the surgical and medical management of the foot and ankle. Each bi-monthly, peer-reviewed issue addresses relevant topics to the profession, such as: adult reconstruction of the forefoot; adult reconstruction of the hindfoot and ankle; diabetes; medicine/rheumatology; pediatrics; research; sports medicine; trauma; and tumors.