Lack of correlation between plantar arthrosis of the first metatarsal joint and sesamoids and pain in patients after hallux valgus surgery

OBJECTIVES
To determine the relationship between osteoarthritis in the plantar region of the first metatarsophalangeal joint of the foot and patient pain after hallux valgus surgery.

MATERIAL AND METHODS
A total of 28 patients undergoing hallux valgus surgery were examined. The patients were examined for pain in the plantar region of the metatarsophalangeal joint (sesamoid bones area), by looking into their medical records and by means of palpation during the physical exam. X-rays were taken to look for metatarsophalangeal arthritis, and PASA and sesamoid displacement were measured. During the surgical procedure, the metatarsal head was macroscopically assessed for arthritis according to the ICRS Score.

RESULTS
Of the 28 patients, 18 had no pain, 7 had mild pain (VAS 1-3) and 3 had moderate pain (VAS 4-6). Macroscopically, all the patients had some degree of plantar osteoarthritis. Only 5 patients had radiological signs of metatarsophalangeal arthritis. There was no correlation (P=.44) between pain and plantar osteoarthritis. There was a mild but non-significant correlation between PASA and osteoarthritis (P=.06). There was a weak but significant correlation between patient age and arthritis (P=.04).

CONCLUSION
Osteoarthritis in the plantar aspect of the first metatarsal head does not correlate with patient symptoms or with pain intensity in patients undergoing hallux valgus surgery.

CITA DEL ARTÍCULO Rev Esp Cir Ortop Traumatol. 2012 March - April;56(2):115-119. Epub 2011 Nov 26