Foot & ankle international最新文献

{"title":"Long-term Outcomes After First Metatarsophalangeal Joint Arthrodesis: With Focus on Degenerative Changes on Adjacent Joints.","authors":"Simon Recheis, Dietmar Mattausch, Nils Kuehn, Harald Kindermann, Reinhold Ortmaier, Martin Bischofreiter, Thomas Stumpner","doi":"10.1177/10711007261441611","DOIUrl":"10.1177/10711007261441611","url":null,"abstract":"<p><strong>Background: </strong>First metatarsophalangeal joint arthrodesis is a reliable treatment for painful end-stage degenerative, inflammatory, and post-traumatic conditions and severe deformities of the first ray. Although long-term functional outcomes are well documented, the incidence and relevance of degenerative changes in adjacent joints of the medial column after first metatarsophalangeal joint (MTP1) fusion remain uncertain.</p><p><strong>Methods: </strong>This exploratory single-center follow-up study included patients who underwent isolated MTP1 arthrodesis between 2012 and 2018. Preoperative and final follow-up weight-bearing radiographs were assessed for osteoarthritis progression in the interphalangeal (IP), tarsometatarsal (TMT1), naviculocuneiform (NC), and talonavicular (TN) joints using the Kellgren-Lawrence classification. Radiographic alignment parameters (hallux valgus angle, intermetatarsal angle, hallux-ground angle, and dorsal extension angle) were recorded. Clinical outcome was evaluated using American Orthopaedic Foot & Ankle Society hallux metatarsophalangeal-interphalangeal score (AOFAS HMI) score, Foot and Ankle Outcome Score (FAOS), Foot Function Index (FFI), and a study-specific questionnaire. Paired statistical tests and Pearson correlation analyses were performed.</p><p><strong>Results: </strong>Seventy-seven patients (45 female, 32 male) were available for follow-up at a mean of 106.9 ± 25.3 months. Radiographic osteoarthritis progression was significant in all assessed adjacent joints (<i>P</i> < .001) and was most pronounced in the IP joint (66 of 77 joints; 34 of 77 joints progressed by ≥2 grades). TMT1 progression occurred in 23 of 77 joints (≥2 grades in 5 of 77 joints), and NC or TN progression in 30 of 77 joints (≥2 grades: NC 6 of 77, TN 8 of 77). Radiographic alignment was not associated with adjacent-joint osteoarthritis progression, metatarsalgia, or patient-reported outcome. Overall, 90.9% reported good or excellent satisfaction. The mean AOFAS HMI score was 79.9 ± 9.1, FAOS 86.4 ± 15.2, and FFI 18.5% ± 9.3%. Wound healing complications were more frequent with dorsal plating than screw fixation. One nonunion required revision.</p><p><strong>Conclusion: </strong>MTP1 arthrodesis provides excellent long-term satisfaction and functional outcomes with low revision rates. Although radiographic adjacent-joint degeneration, particularly involving the interphalangeal joint, may occur over time, these changes do not appear to influence clinical outcomes.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"955-961"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148220711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimally Invasive vs Open Lapidus Bunionectomy: 1-Year Patient-Reported Outcomes.","authors":"Lance M Ward, Isabel R Voellmicke, Dwayne D Carney, Rebekah Belayneh, Amanda Zeng, Rachel Thompson, Agnes Cororaton, A Holly Johnson, Scott J Ellis","doi":"10.1177/10711007261446621","DOIUrl":"10.1177/10711007261446621","url":null,"abstract":"<p><strong>Background: </strong>Hallux valgus is a common and potentially debilitating foot deformity, and the modified Lapidus is a prominent corrective procedure in the United States. The clinical distinctions between the minimally invasive surgery (MIS) and the established open techniques for modified Lapidus have not yet been well-described, particularly in the context of patient-reported outcomes. This study aims to systematically compare patient-reported outcomes between the 2 surgical approaches.</p><p><strong>Methods: </strong>One hundred forty moderate to severe hallux valgus patients who received modified Lapidus (66 MIS, 74 open) were identified via retrospective review. Patient-Reported Outcomes Measurement Information System (PROMIS) scores were used to assess clinical outcomes preoperatively and at 1 year postoperatively. Hallux valgus angle (HVA) and 1-2 intermetatarsal angle (IMA) were measured on radiographs. Meary angle, first-ray length, first-ray elevation, first-ray pronation, and sesamoid position were analyzed on weightbearing computed tomography (WBCT). Surgical complications were identified through chart review and radiographic assessments.</p><p><strong>Results: </strong>MIS and open Lapidus patients reported clinically meaningful improvements in PROMIS physical function, pain interference, pain intensity, and global physical health scores at 1 year postoperatively, along with modest changes in global mental health and depression scores. There were no statistically significant differences in PROMIS scores between groups (adjusted <i>P</i> > .05, 95% CIs excluding zero). Although both techniques reliably achieved excellent correction, there was greater correction of HVA (3.82°) and IMA (2.02°) in open Lapidus patients and greater correction of Meary angle (3.16°) in MIS patients (adjusted <i>P</i> < .05, 95% CIs excluding zero). Rates of nonunion, recurrence, infection, and hardware removal were not statistically significant between surgical cohorts.</p><p><strong>Conclusion: </strong>With the numbers available, no statistically significant difference was detected between the MIS and open Lapidus groups across all collected PROMIS measures, implying that the foot and ankle surgeon can expect to see similar patient-reported outcomes at 1 year postoperatively using either approach.</p><p><strong>Level of evidence: </strong>Level III, retrospective cohort study.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"1000-1010"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148521747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Staging Strategies for the Infected, Deformed Foot.","authors":"Doug Beaman, Paul T Fortin","doi":"10.1177/10711007261457417","DOIUrl":"10.1177/10711007261457417","url":null,"abstract":"","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"974-975"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148355196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term Clinical and Radiographic Outcomes After Salto Talaris Total Ankle Arthroplasty: Long-term Follow-up of a Previously Published Cohort.","authors":"Joshua Slowinski, Ellen Lutnick, Nicholas Frappa, Gabrielle Orie, Jamie Bousleiman, Christopher Ritter","doi":"10.1177/10711007261443281","DOIUrl":"10.1177/10711007261443281","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to demonstrate long term clinical follow-up and implant survivorship of Salto Talaris-type primary total ankle arthroplasty (TAA) by 1 foot and ankle-trained surgeon at a single institution.</p><p><strong>Methods: </strong>Patients treated with primary Salto Talaris TAA were identified via <i>Current Procedural Terminology</i> (<i>CPT</i>) codes and included if they underwent primary TAA without history of arthrodesis and had complete imaging, clinical evaluation, and patient-reported outcomes preoperatively. Implant survivorship was calculated considering revision as requiring metal component explantation. Patient outcomes at final follow-up were compared to available preoperative values via paired <i>t</i> tests. <i>P</i> <.05 was considered significant.</p><p><strong>Results: </strong>A total of 154 patients met inclusion (55.8% female, mean age at surgery 63.3 ± 8.9 years). Mean follow-up was 9.7 years (range, 0.6-17.6 years). Estimated implant survival probability was 100% at 1 year, 97.2% at 3 years (95% CI 94.6-99.9), 94.9% at 5 years (95% CI 91.3-98.7), 91.6% at 10 years (95% CI 86.7-96.9), and 86.9% at both 12 and 15 years (95% CI 79.3-95.3); no component explantation events occurred between 12 and 15 years, with the final explantation recorded at 15.28 years postoperatively. Thirteen patients underwent revision. There was no significant change in dorsiflexion but a reduction in plantarflexion (Δ = -4.3°, 95% CI -6.0 to -2.6; <i>P</i> < .001) at final follow-up. No significant changes were observed comparing radiographs at 6-week and final follow-up, including tibial component coronal alignment, posterior tibial slope, and talar component position. Among 87 patients (91 TAA) with complete long-term data, VAS pain decreased (Δ = -26.5, 95% CI -33.0 to -20.0; <i>P</i> < .001), mean FCS 12 increased (Δ = +20.9, 95% CI 18.7-23.2; <i>P</i> < .001), and MCS increased (Δ = +5.2, 95% CI 2.9-7.5; <i>P</i> < .001). All FAOS subscales improved significantly (<i>P</i> < .001).</p><p><strong>Conclusion: </strong>This cohort suggests that Salto Talaris-type TAA is associated with durable survivorship and patient outcomes at long-term follow-up in this single-surgeon series.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"1019-1028"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147978172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Modified Ponseti Method for Skeletally Mature Complex Foot Deformities.","authors":"Brandon Zaldivar, Jaime Alfredo Schuster-Wasserman, Martha Lorena Caicedo-Gutiérrez, Adriana Victoria Cogua-Rodríguez, Diana Paola Montoya-Murillo, Diego Fernando Ortiz-Montoya","doi":"10.1177/10711007261456735","DOIUrl":"10.1177/10711007261456735","url":null,"abstract":"<p><strong>Background: </strong>Managing skeletally mature complex foot deformities (CFDs) remains challenging, and the effectiveness of the Ponseti method (PM) beyond childhood is not established. This study assesses improvements in foot deformity among adolescent and adult patients with idiopathic and acquired CFD treated with serial casting as a presurgical correction strategy.</p><p><strong>Methods: </strong>A retrospective cohort study encompassing 58 skeletally mature patients (78 feet) with idiopathic or acquired CFD treated with a modified PM between 2020 and 2024 was conducted. Patients were categorized by etiology, and deformity severity in cavus, varus, adductus, and equinus was documented at baseline, after casting, and postoperatively. Analysis of variance and Tukey honestly significant difference test assessed changes over time. Postoperative and casting complications, relapses, and Foot and Ankle Outcome Score (FAOS) were reported at final follow-up.</p><p><strong>Results: </strong>Twenty-eight patients with idiopathic CFD and 30 with acquired CFD were studied. After casting, 95% (55/58) required additional procedures. A plantigrade foot was achieved in 89% (69/78). Seventy-seven percent (60/78) of feet required procedures in addition to Achilles tenotomy. Improvements across all deformity planes were attributable to serial casting (<i>P</i> < .001), and postoperatively, equinus improved significantly (<i>P</i> < .04 and <i>P</i> < .01) in both groups. Casting-related injuries needing wound care occurred in 8.9% (7/78). After a median follow-up of 17 months, 13% (10/78) experienced relapse. Postoperative complications included 1 wound dehiscence and 1 case of stiffness. The median FAOS for idiopathic and acquired groups were 87 and 85, respectively.</p><p><strong>Conclusion: </strong>A modification of the PM, using serial leg casting as a preoperative correction strategy for idiopathic and acquired CFD was associated with reduced need for, or reduced complexity of, major reconstructive foot surgery, with high rates of plantigrade feet and low rates of arthrodesis. This approach could redefine treatment paradigms in resource-constrained settings and for multiplanar correction of foot deformity.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"1036-1047"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148474847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distal Oblique Osteotomy vs Arthrodesis for Advanced Hallux Rigidus: A Matched Cohort Study.","authors":"Jia Ying Lee, Jonathan Koh Ern Juan, Rui Xiang Toh, Khizer Shajahan Mohamed Buhary, Zongxian Li, Kae Sian Tay","doi":"10.1177/10711007261456291","DOIUrl":"10.1177/10711007261456291","url":null,"abstract":"<p><strong>Background: </strong>Arthrodesis is regarded as the gold standard for advanced hallux rigidus, providing reliable pain relief but at the cost of first metatarsophalangeal (MTP) joint motion and implant-related complications. Distal oblique osteotomy (DOO) is a joint-preserving alternative that addresses dorsal impingement and altered biomechanics, but direct comparisons with arthrodesis in advanced disease remain limited.</p><p><strong>Methods: </strong>This study retrospectively reviewed prospectively collected registry data from a single tertiary orthopaedic centre. Patients with advanced hallux rigidus who underwent first MTP joint arthrodesis or DOO after failing conservative management were included. Cohorts were matched for age, sex, body mass index, radiographic severity, and hallux valgus angle; however, residual differences remained between cohorts. Clinical outcomes assessed at a minimum of 24 months included patient satisfaction, complications, revision surgery rates, visual analogue scale (VAS) pain, American Orthopaedic Foot & Ankle Society (AOFAS), and range of motion (ROM) scores.</p><p><strong>Results: </strong>Fifty-nine patients were included (arthrodesis = 28; DOO = 31). Both groups showed improvements in pain and function postoperatively. Patient satisfaction rates (arthrodesis = 25 [89.3%] vs DOO = 28 [90.3%], <i>P</i> > .05) and satisfaction score (arthrodesis = 2.14 [1.04] vs DOO = 1.84 [1.07], <i>P</i> > .05) were similarly high. The overall complication rate was lower (<i>P</i> = .025) in the DOO group (3.2%) compared with the arthrodesis group (28.6%), although complication profiles differed between procedures. Revision surgery rates were lower following DOO, although this difference was not statistically significant. AOFAS scores were higher in the DOO group, whereas the ROM was expectedly greater following DOO (<i>P</i> < .05), whereas postoperative VAS pain scores were comparable between groups.</p><p><strong>Conclusion: </strong>DOO may represent a motion-preserving surgical option for selected patients with advanced hallux rigidus. In this study, DOO was associated with comparable patient satisfaction and pain relief to arthrodesis, with preservation of joint motion and lower observed complication rates. These findings suggest that DOO may be considered as an alternative in appropriate patients, although further prospective studies are required.</p><p><strong>Level of evidence: </strong>Level III, retrospective cohort study.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"976-985"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148355172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Surgical Complication Rates Following Elective Minimally Invasive Surgery Hallux Valgus in Diabetic Patients: A Matched Cohort Analysis.","authors":"Virginia M Cafruni, Ana C Parise, Leonardo Conti, Pablo Sotelano, Facundo Bilbao, Maria G Santini-Araujo","doi":"10.1177/10711007261444266","DOIUrl":"10.1177/10711007261444266","url":null,"abstract":"<p><strong>Background: </strong>The objective of this study was to assess the types and rates of early complications following elective percutaneous surgery for hallux valgus (HV) in diabetic (DP) vs non-diabetic (NDP) patients.</p><p><strong>Method: </strong>This retrospective study was conducted at our institution between October 2017 and August 2020. During this period, 874 feet underwent percutaneous surgery for HV correction. All adult diabetic patients with controlled diabetes who underwent percutaneous distal metaphyseal osteotomy and had a minimum follow-up of 6 months were included. For each diabetic patient, 2 age-matched (±1 year) non-diabetic controls were randomly selected. Complications were defined as any deviation from the normal postoperative course and were systematically recorded. This work is a retrospective exploratory analysis of a matched cohort.</p><p><strong>Results: </strong>A total of 75 patients were analyzed, 25 DP and 50 NDP, with a mean follow-up of 10.8 months (range 6-48) months. There were no significant differences in demographic characteristics between groups, except for body mass index and Charlson Comorbidity Index, both of which were significantly higher in the DP group (<i>P</i> < .001 and <i>P</i> = .014, respectively). Although pre- and postoperative functional scale scores did not differ significantly between the groups, the postoperative radiographic angles showed a greater correction in the diabetic group.The overall complication rate was 24% (n = 6) in the DP group and 18% (n = 9) in the NDP group (<i>P</i> = .553). Complications included infection, osteosynthesis discomfort, pseudarthrosis, residual pain, and metatarsalgia. In the DP group, all superficial infections were successfully managed with oral antibiotics.</p><p><strong>Conclusion: </strong>With the available sample size, no statistically significant differences in the overall complication rate were detected between well-controlled diabetic and non-diabetic patients undergoing minimally invasive hallux valgus surgery. These findings should be interpreted as exploratory and hypothesis-generating, and require confirmation in larger studies.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"986-992"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148059056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-Reported Outcomes and Satisfaction Results on a Modern Fixed-Bearing Total Ankle Arthroplasty: Updated Mean 6-Year Follow-up.","authors":"Daisy L Lang, Blake R McReavy, Ryan K Moen, Rebecca Stone McGaver, Jacquelyn E Fritz, Kayla J Seiffert, J Chris Coetzee","doi":"10.1177/10711007261454946","DOIUrl":"10.1177/10711007261454946","url":null,"abstract":"<p><strong>Background: </strong>Early results of the fixed-bearing total ankle arthroplasty (TAA) have demonstrated improvement in patient-reported outcome measures (PROMs) for patients with end-stage ankle arthritis. The purpose of this study is to update the previously reported PROMs for the largest cohort of US patients undergoing modern fixed-bearing TAA with the Salto Talaris implant.</p><p><strong>Methods: </strong>A retrospective review was completed of 300 consecutive patients who underwent implantation with 321 modern fixed-bearing TAA by a single surgeon. PROMs were collected prior to surgery, at 3 and 6 months, and yearly thereafter. Collected outcome measures included Veterans RAND 12-Item Health Survey (VR-12), Ankle Osteoarthritis Scale (AOS), and visual analog pain scale (VAS). Presurgical and latest available follow-up (>2 years) PROMs were compared using a mixed effect linear regression with significance level alpha = 0.01 using a Bonferroni-adjusted significance threshold to account for testing across the 5 PROMs.</p><p><strong>Results: </strong>Of the 321 TAAs, an updated 300 procedures (282 patients) had a minimum 2-year follow-up. The average follow-up was 75.3 (range, 24-193.9) months. The mean physical VR-12 score increased significantly from prior to surgery to latest follow-up, while mental VR-12 scores did not (<i>P</i> < .001 and <i>P</i> = .608, respectively). AOS pain and disability scores and VAS pain scores improved significantly (<i>P</i> < .001). Clinical significance of PROMs was assessed using previously reported minimal clinically important differences (MCIDs), and the average changes in VR-12 physical composite score, AOS Pain and Disability scores, and VAS scores from preoperation to latest follow-up were all greater than the respective MCID values.</p><p><strong>Conclusion: </strong>At midterm follow-up, fixed-bearing TAA with the Salto Talaris implant was associated with improvement in quality of life, pain, and disability.</p><p><strong>Level of evidence: </strong>Level IV, case series.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"1029-1035"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148341542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter Regarding: Radiologic Progression of Talar Osteochondral Lesions with Subchondral Cyst: A Median 98-Month Observational Study.","authors":"Jari Dahmen, Julian J Hollander, Gino M M J Kerkhoffs","doi":"10.1177/10711007261460438","DOIUrl":"10.1177/10711007261460438","url":null,"abstract":"","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"1082-1083"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient acceptable symptom state for European Foot and Ankle Society Score After Hallux Valgus Surgery.","authors":"Hong Jing Lee, Khye Soon Andy Yew, William Yeo, Kizher Shajahan Mohamed Buhary, Rui Xiang Toh, Zongxian Li, Kae Sian Tay","doi":"10.1177/10711007261444286","DOIUrl":"10.1177/10711007261444286","url":null,"abstract":"<p><strong>Background: </strong>The European Foot & Ankle Society (EFAS) Score is a validated patient-reported outcome measure for the evaluation of postoperative foot and ankle outcomes. Yet, unlike the AOFAS, there is a dearth of literature defining the patient acceptable symptom state (PASS) for EFAS after hallux valgus surgery. This study aimed to determine the PASS for EFAS after hallux valgus surgery.</p><p><strong>Methods: </strong>This was a retrospective cohort study using prospectively collected data of patients who underwent hallux valgus surgery between May 2017 and September 2023 in the authors' institution. Patients were evaluated preoperatively and at 6 months and 2 years postoperatively, using functional outcomes such as EFAS and American Orthopaedic Foot & Ankle Society (AOFAS) Hallux Metatarsophalangeal-Interphalangeal Rating System. PASS thresholds were determined with the Youden Index on receiver operating characteristic curves, with responses to an anchor question as the external criterion.</p><p><strong>Results: </strong>A total of 361 patients were followed up for 2 years. This included 324 (89.8%) female and 37 (10.2%) male patients. The mean age and body mass index (BMI) was 56.0 ± 14.0 years and 24.1 ± 4.6, respectively. Patients underwent various procedures including scarf-Akin osteotomy (n = 220, 60.9%), minimally invasive chevron-Akin osteotomy (n = 102, 28.3%), arthrodesis of first metatarsophalangeal joint (n = 15, 4.2%), scarf osteotomy (n = 14, 3.9%), Lapidus procedure (n = 7, 1.9%), and Bosch osteotomy (n = 3, 0.8%). The PASS for EFAS was determined to be 20.5 at 6 months (sensitivity 86.8%, specificity 70.4%) and 23.5 at 2 years (sensitivity 87.2%, specificity 72.0%). However, the PASS for AOFAS was determined to be 84.5 at 6 months (sensitivity 72.6%, specificity 75.0%) and 82.5 at 2 years (sensitivity 90.9%, specificity 63.4%).</p><p><strong>Conclusion: </strong>The PASS for EFAS established in this study can be used for the clinical interpretation of future hallux valgus studies. A potential ceiling effect of the EFAS was identified, and the revised AOFAS PASS thresholds may warrant consideration.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"1061-1071"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148207427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}