Patient expectations in hallux valgus surgery: A qualitative analysis

Abstract

This study provides an in-depth exploration of patient expectations with hallux valgus surgery using a qualitative approach. Twenty patients awaiting surgery for symptomatic hallux valgus completed a 20-minute semi-structured interview to elicit rich, nuanced information regarding their expectations for bunion surgery. Interviews were transcribed and independently coded by three reviewers. Codes were combined and analyzed by three reviewers to produce over-arching themes that represented patients' goals for surgery. Pain and activity were key decision making factors influencing both the decision to pursue surgery and in defining surgical success. Many participants feared worsening pain and progression of deformity if left untreated. Cosmetic appearance was an important concern, but was secondary to pain, activity and functional ability. Participants valued clear, comprehensive instructions from their care team regarding their immediate postoperative care. Lastly, we observed wide variability in expectations regarding the postoperative recovery timeline, suggesting a greater need for providing rehabilitation timelines that better align expectations with clinical reality. These findings provide evidence that hallux valgus deformity, in the eyes of our patients, is a disabling musculoskeletal condition which can substantially restrict daily activities. Additionally, this work offers insight into patients' goals and motivations for pursuing hallux valgus surgery and highlights potential areas for improved dialog during preoperative consultations.