Preoperative patient-reported depression and anxiety may affect short-term surgical outcomes in women with hallux valgus.

Abstract

Preoperative anxiety may influence surgical outcomes, but its specific impact on hallux valgus (HV) surgery remains unclear. This study evaluated the association between preoperative anxiety and postoperative outcomes in female patients who underwent HV correction. In this retrospective comparative study, 163 female patients who underwent primary HV correction were included. Patients were categorized into anxiety (Zung Self-Rating Anxiety Scale [SAS] ≥ 40, n = 48) and nonanxiety (SAS < 40, n = 115) groups. The outcomes included radiographic parameters (hallux valgus angle [HVA], intermetatarsal angle [IMA]), pain (visual analog scale [VAS]), functional outcomes (Foot and Ankle Ability Measure [FAAM], and American Orthopaedic Foot and Ankle Society [AOFAS] score), quality of life (36-Item Short Form Health Survey [SF-36] Physical Function), complications, and length of hospital stay. Multivariate analyses adjusted for potential confounders. There were no significant differences in age, body mass index (BMI), education level, or radiographic parameters between the groups. Anxiety patients had longer hospital stays than nonanxiety patients did (7.03 ± 3.23 vs. 5.16 ± 2.53 days; p < 0.001). Postoperatively, the anxiety group had a higher VAS score (4.14 ± 1.56 vs. 1.24 ± 1.37; p < 0.001) and lower FAAM Activities of Daily Living (ADL), FAAM Sports, AOFAS (85.42 ± 11.54 vs. 91.38 ± 10.11; p = 0.001), and SF-36 PF (83.72 ± 7.36 vs. 94.62 ± 5.42; p < 0.001) scores. Anxiety was moderately correlated with HVA (r = 0.625; p < 0.01). Anxiety severity showed a strong dose-dependent association with functional impairment (FAAM Sports, r = - 0.913) and pain (VAS, r = 0.821). Preoperative anxiety is associated with short-term suboptimal postoperative outcomes following hallux valgus surgery, particularly greater pain and worse functional recovery. These findings suggest that preoperative psychological assessments and targeted psychological support may be valuable components of comprehensive surgical care for female patients undergoing hallux valgus correction. Level III, retrospective comparative study.