Patient Regret Following Corrective Surgery for Hallux Valgus

Research Type: Level 3 - Retrospective cohort study, Case-control study, Meta-analysis of Level 3 studies Introduction/Purpose: Hallux valgus is a common deformity of the foot resulting in pain and impaired mobility, with numerous surgical techniques to improve patient quality of life. This study aims to determine the relationship between the type of bunion fixation procedure performed and patient regret with the decision to undergo surgery. Methods: A retrospective review was conducted of 168 patients with a diagnosis of bunion or hallux valgus that bunion correction surgery from 2015-2023, with minimum 1 year follow-up (mean=3.24; range=1.05-6.51). Of the overall cohort, 84 (50.0%) underwent Chevron bunionectomies (with or without akin osteotomy), 49 (29.2%) 1st MTP fusions, 28 (16.7%) Lapidus bunionectomies (with or without akin osteotomy), and 7 (4.2%) Akin osteotomies. Patients were given an overall regret score and separated into regret categories: 52 reported no regret (31.0%), 76 reported low regret (45.2%), 15 reported medium regret (8.9%), and 25 reported high regret (14.9%). Results: Participants were mostly female (82.7%) with an average age of 59.50 (range 16-93) years. 83.3% of participants agreed that surgery was the right decision for them, and 73.2% stated they would make the same choice in the future. Whereas 19.0% regretted the decision and 16.1 % reported the operation brought them harm. 27.34% of women experienced medium or high regret; whereas, only 6.9% of males experienced medium or high regret. This difference in regret across gender was not significant. Divorced patients were significantly more likely to be in higher regret categories (Divorced=43.48%, married=20.62%, single=18.92%, widowed=27.27%). Additionally, the Lapidus procedure had a significantly higher percentage of patients reporting medium or high regret (46.4%). Conclusion: The majority of patients that underwent a bunion fixation procedure believed that surgery was the right decision. Divorced patients and those who underwent a Lapidus bunionectomy reported higher levels of regret following corrective surgery.