Predicting Treatment Success after Scarf Osteotomy for Hallux Valgus using The American Orthopedic Foot and Ankle Society and Short Form Health Survey Scores
Meng Zhu, Jerry Y Chen, Terry HL Teo, Kevin OT Koo, Inderjeet S Rikhraj
Hallux valgus, Patient-reported outcome, Scarf osteotomy, The American Orthopedic Foot and Ankle Society- Health Management Information System, Threshold score, Treatment success
Citation Information :
Zhu M, Chen JY, Teo TH, Koo KO, Rikhraj IS. Predicting Treatment Success after Scarf Osteotomy for Hallux Valgus using The American Orthopedic Foot and Ankle Society and Short Form Health Survey Scores. J Foot Ankle Surg Asia-Pacific 2018; 5 (2):59-63.
Aim: Various hallux valgus corrective surgeries, including Scarf osteotomy, have demonstrated improvement in patients' forefoot function and quality of life. However, no threshold values of these measures have been reported to define the success of surgery from the patients' perspective. This study aims to define treatment success threshold values of The American Orthopedic Foot and Ankle Society (AOFAS)-Health Manage-ment Information System (HMIS) and Short Form (36) Health Survey (SF-36) Scores for patients underwent Scarf osteotomy (SO) for hallux valgus.
Materials and methods: A retrospective analysis of patients who underwent scarf osteotomy between 2007 and 2013 was conducted. Patients were evaluated for AOFAS-HMIS, SF-36 score, satisfaction, and pain scoreatvarious time points. Treatment success was defined as a significant improvement in pain and satisfaction with surgery. Using receiver operating characteristic (ROC) analysis, threshold score for treatment success was defined as the cut-off value providing the largest sum of sensitivity and specificity.
Results: A total of 360 and 345 patients completed assessments at 6-month and 2-year after surgery, with a success rate of 70.0% and 77.4%, respectively. The AOFAS-HMIS and physical component score (PCS) improved significantly atboth postoperative time points as compared to preoperatively. The ROC analyses revealed the excellent predictive value of AOFAS-HMIS for treatment success (AUC = 0.840 and 0.835).
Conclusion: The American Orthopedic Foot and Ankle Society-Health Management Information System of 84 and above at 6-month, or 89 and above at 2-year after surgery can be used to define treatment success of OS for hallux valgus. Anincreasingly higher threshold is required to define treatment success with time.
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