Risk factors for the progression of hallux valgus angle on radiography in Japanese adults.

Nishimura, Akinobu; Senga, Yoshiyuki; Fujikawa, Yuki; Konno, Chihiro; Sudo, Akihiro; Hasegawa, Masahiro · J Orthop Sci · 2025

prospective_cohort · Level II

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Abstract

Hallux valgus (HV) is common in middle-aged and older adults. However, previous studies that linked HV to factors such as sex, knee osteoarthritis, footwear, and aging were mostly cross-sectional. This longitudinal study aimed to investigate HV risk factors and progression. Serial radiographs were assessed in Japanese mountain villagers aged ≥50 years who underwent at least two health checkups within an interval of 4 or more years. Demographic data, medical history, and radiographic measurements were collected. We included 271 participants (542 feet; mean age: 69.6 years); the mean follow-up period was 6.7 years. The average annual change in the HV angle (HVA) was 0.19°. In 16.1 % of the feet, the HVA increased by ≥ 1°/year. Lateral tibial sesamoid bone positioning was a significant risk factor for HV. HVA progression was less likely in adults aged ≥50 years without tibial sesamoid bone malposition.