Hallux valgus with and without metatarsalgia in women: a matched-cohort study of plantar pressure measurements

Carmen Verdu Roman; Enrique Martinez Gimenez; David Bustamante Suarez de Puga; Jesus Mas Martinez; Manuel Morales Santias; Javier Sanz-Reig

doi:10.1007/s43465-021-00416-3

Hallux valgus with and without metatarsalgia in women: a matched-cohort study of plantar pressure measurements

Indian J Orthop. 2021 May 19;55(Suppl 2):436-444. doi: 10.1007/s43465-021-00416-3. eCollection 2021 Jul.

Authors

Carmen Verdu Roman¹, Enrique Martinez Gimenez¹, David Bustamante Suarez de Puga¹, Jesus Mas Martinez¹, Manuel Morales Santias¹, Javier Sanz-Reig¹

Affiliation

¹ Foot and Ankle Unit, Department of Orthopaedic Surgery, Clinica HLA Vistahermosa, Av de Denia 76. 03016. Alicante, Spain.

Abstract

Background: Few previous studies focused on plantar loading patterns in HV patients with metatarsalgia. Are there any differences in plantar pressure measurements in women with HV with and without metatarsalgia?

Methods: A prospective matched-cohort study was designed to analyze plantar pressure measurements in women with HV with and without metatarsalgia from January 2017 to December 2019. The inclusion criteria were age over 18 years old, women, diagnosis of HV with metatarsalgia. Control group had the same inclusion criteria, except metatarsalgia. Patient-reported outcomes scores included American Orthopedic Foot and Ankle Society Score (AOFAS), and Visual Analog Scale (VAS). Radiographic data were obtained according to the guidelines of the AOFAS Committee on Angular Measurements. Plantar pressure measurements were performed using a platform.

Results: Forty-seven patients met the inclusion criteria. An age-, BMI-, and hallux valgus angle-matched cohort of 47 patients were also selected. There were no statistically significant differences in demographic data and radiographic assessment. HV with metatarsalgia group showed greater values in peak and mean force, peak and mean pressure, and pressure-time integral under toes and metatarsal heads. These differences reached statistically significant in mean force (p = 0.009) and peak force (p = 0.003) under T1; mean pressure (p = 0.01) and peak pressure (p = 0.04) under T1; and mean force (p = 0.003) under MH1. The binary logistic regression analysis showed mean force under T1 as the most associated plantar pressure measurement with the presence of metatarsalgia. C-statistic was 0.66. Mean force > 35 N had a 70% of sensitivity and a 57% of specificity as a cut-off value for the presence of metatarsalgia.

Conclusion: HV patients with metatarsalgia had greater values in plantar pressure measurements. Mean force under T1 could be used as a plantar pressure measurement to predict metatarsalgia.

Keywords: Hallux valgus; Metatarsalgia; Plantar pressure; Women.