Factors associated with hallux valgus in a community-based cross-sectional study of adults with and without osteoarthritis

Abstract

Objective To determine whether hallux valgus (HV) was associated with potential risk factors, including foot pain in a large, biracial cohort of older men and women. Methods We conducted a cross-sectional analysis of cohort members of the Johnston County Osteoarthritis Project, of whom 1,502 had complete clinical and demographic data available (mean age 68 years, mean body mass index [BMI] 31.3 kg/m2, 68% women, and 30% African American). The presence of HV was assessed visually using a validated examination. Multivariate logistic regression models with generalized estimating equations for the total sample and for each sex and race subgroup were used to examine the effect of age, BMI, foot pain, pes planus, and knee or hip radiographic osteoarthritis (OA) on HV. Results HV was present in 64% of the total sample (69% for African American men, 70% for African American women, 54% for white men, and 65% for white women). The association between HV and foot pain was elevated but not statistically significant (adjusted odds ratio [aOR] 1.21, 95% confidence interval 0.99-1.47). Women, African Americans, older individuals, and those with pes planus or knee/hip OA had significantly higher odds of HV (aOR 1.17-1.48). Participants with higher BMI had lower odds of HV compared to those with normal BMI (aOR 0.54-0.72). Overall, patterns of associations were similar across subgroups. Conclusion HV was associated with female sex, African American race, older age, pes planus, and knee/hip OA, and inversely associated with higher BMI. Early prevention and intervention approaches may be needed in high-risk groups; longitudinal studies would inform these approaches.