Advertisement

International Orthopaedics

, Volume 43, Issue 6, pp 1443–1447 | Cite as

The impact of body mass index on metatarsalgia surgical outcomes

  • Daniel Pérez-PrietoEmail author
  • Marta Cuenca
  • Raquel Marí
  • Raquel Martínez
  • Gemma González
  • Alberto Ginés
Original Paper
  • 49 Downloads

Abstract

Introduction

Several studies have suggested that an increased body mass index (BMI) is a negative factor for forefoot plantar pain but its influence in the surgical correction of metatarsalgia is unknown. The purpose of the present study is to evaluate the influence of the BMI on the surgical outcomes of metatarsalgia. It has been hypothesized that the higher the BMI, the worse the functional outcomes after metatarsalgia surgical treatment at one year follow-up.

Material and methods

A prospective cohort study that included all patients operated on for third rocker metatarsalgia was conducted. Weil’s osteotomy was performed on all the patients operated on. The patients’ pre-operative height, weight, and BMI were recorded. The patients were subsequently divided into three groups based on their BMI. There was group 1 or the normal group (18.5 > BMI ≤ 25 kg/m2), group 2 or the overweight group (25 > BMI ≤ 30 kg/m2), and group 3 or the obese group (BMI > 30 kg/m2). Pre-operative, post-operative, and differential AOFAS were used to evaluate and compare the groups. The post-operative VAS was also measured to assess pain. The correlation between the BMI and those variables was also analyzed.

Results

After the exclusion criteria were applied, 107 patients were finally assessed. There were 22 patients (20.6%) in group 1, 52 patients (48.6%) in group 2, and 33 patients (30.8%) in group 3. No correlation was observed between the BMI and AOFAS (p > 0.05). Neither were any differences found when the three groups were compared (p > 0.05). Moreover, no correlation between the BMI and the VAS score was observed (p = 0.690).

Conclusion

Obesity does not negatively influence functional outcomes after surgery for metatarsalgia in short to medium term. Regardless of their BMI, patients with propulsive metatarsalgia improve in functionality after surgical treatment.

Keywords

BMI Obesity Metatarsalgia surgical outcomes Forefoot disorders 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Statement of informed consent

All patients gave informed consent prior to participating in this investigation.

Supplementary material

264_2018_4067_MOESM1_ESM.xlsx (36 kb)
ESM 1 (XLSX 36 kb).

References

  1. 1.
    Cheng FW, Gao X, Bao L et al (2017) Obesity as a risk factor for developing functional limitation among older adults: a conditional inference tree analysis. Obes Silver Spring Md.  https://doi.org/10.1002/oby.21861
  2. 2.
    Shaw K, Gennat H, O’Rourke P, Del Mar C (2006) Exercise for overweight or obesity. Cochrane Database Syst Rev CD003817 .  https://doi.org/10.1002/14651858.CD003817.pub3
  3. 3.
    Welborn TA, Knuiman MW, Vu HT (2000) Body mass index and alternative indices of obesity in relation to height, triceps skinfold and subsequent mortality: the Busselton health study. Int J Obes Relat Metab Disord J Int Assoc Study Obes 24:108–115CrossRefGoogle Scholar
  4. 4.
    Nunez M, Nunez E, del Val JL et al (2007) Health-related quality of life in patients with osteoarthritis after total knee replacement: factors influencing outcomes at 36 months of follow-up. Osteoarthr Cartil 15:1001–1007.  https://doi.org/10.1016/j.joca.2007.02.019 CrossRefGoogle Scholar
  5. 5.
    Torres-Claramunt R, Hinarejos P, Leal-Blanquet J et al (2016) Does obesity influence on the functional outcomes of a total knee arthroplasty? Obes Surg 26:2989–2994.  https://doi.org/10.1007/s11695-016-2233-x CrossRefGoogle Scholar
  6. 6.
    Nourissat G, Ciais G, Coudane H (2015) Arthroscopy and obesity. Orthop Traumatol Surg Res OTSR 101:S351–S352.  https://doi.org/10.1016/j.otsr.2015.09.001 CrossRefGoogle Scholar
  7. 7.
    Warrender WJ, Brown OL, Abboud JA (2011) Outcomes of arthroscopic rotator cuff repairs in obese patients. J Shoulder Elb Surg 20:961–967.  https://doi.org/10.1016/j.jse.2010.11.006 CrossRefGoogle Scholar
  8. 8.
    Patel AD, Albrizio M (2007) Relationship of body mass index to early complications in hip replacement surgery: study performed at Hinchingbrooke hospital, orthopaedic directorate, Huntingdon, Cambridgeshire. Int Orthop 31:439–443.  https://doi.org/10.1007/s00264-006-0222-8 CrossRefGoogle Scholar
  9. 9.
    Yeung E, Jackson M, Sexton S et al (2011) The effect of obesity on the outcome of hip and knee arthroplasty. Int Orthop 35:929–934.  https://doi.org/10.1007/s00264-010-1051-3 CrossRefGoogle Scholar
  10. 10.
    Ibrahim T, Hobson S, Beiri A, Esler CN (2005) No influence of body mass index on early outcome following total hip arthroplasty. Int Orthop 29:359–361.  https://doi.org/10.1007/s00264-005-0012-8 CrossRefGoogle Scholar
  11. 11.
    Dufour AB, Losina E, Menz HB et al (2016) Obesity, foot pain and foot disorders in older men and women. Obes Res Clin Pract.  https://doi.org/10.1016/j.orcp.2016.11.001
  12. 12.
    Maestro M, Besse J-L, Ragusa M, Berthonnaud E (2003) Forefoot morphotype study and planning method for forefoot osteotomy. Foot Ankle Clin 8:695–710CrossRefGoogle Scholar
  13. 13.
    Neri SGR, Gadelha AB, Correia ALM, et al (2017) Obesity is associated with altered plantar pressure distribution in elderly women. J Appl Biomech 1–21 . https://doi.org/10.1123/jab.2016-0357
  14. 14.
    Tas S, Bek N, Ruhi Onur M, Korkusuz F (2017) Effects of body mass index on mechanical properties of the plantar fascia and heel pad in asymptomatic participants. Foot Ankle Int 1071100717702463 . https://doi.org/10.1177/1071100717702463
  15. 15.
    Weil LS (1992) A comparison of Biofix rods to rigid internal fixation in the treatment of elective osteotomies in foot surgery. J Foot Surg 31:314Google Scholar
  16. 16.
    Kitaoka HB, Alexander IJ, Adelaar RS et al (1994) Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int 15:349–353.  https://doi.org/10.1177/107110079401500701 CrossRefGoogle Scholar
  17. 17.
    Nair AV, Shamsuddin K, John PS et al (2015) Correlation of visual analogue scale foot and ankle (VAS-FA) to AOFAS score in malleolar fractures using Indian language questionnare. Foot Ankle Surg Off J Eur Soc Foot Ankle Surg 21:125–131.  https://doi.org/10.1016/j.fas.2014.10.006 CrossRefGoogle Scholar
  18. 18.
    Strauss RS, Pollack HA (2001) Epidemic increase in childhood overweight, 1986-1998. JAMA 286:2845–2848CrossRefGoogle Scholar
  19. 19.
    Hills AP, Hennig EM, Byrne NM, Steele JR (2002) The biomechanics of adiposity--structural and functional limitations of obesity and implications for movement. Obes Rev Off J Int Assoc Study Obes 3:35–43CrossRefGoogle Scholar
  20. 20.
    Espinosa N, Maceira E, Myerson MS (2008) Current concept review: metatarsalgia. Foot Ankle Int 29:871–879.  https://doi.org/10.3113/FAI.2008.0000X CrossRefGoogle Scholar
  21. 21.
    Roy KJ (1988) Force, pressure, and motion measurements in the foot: current concepts. Clin Podiatr Med Surg 5:491–508Google Scholar
  22. 22.
    Arnold JB, Causby R, Pod GD, Jones S (2010) The impact of increasing body mass on peak and mean plantar pressure in asymptomatic adult subjects during walking. Diabet Foot Ankle 1:  https://doi.org/10.3402/dfa.v1i0.5518
  23. 23.
    Chen JY, Lee MJH, Rikhraj K et al (2015) Effect of obesity on outcome of hallux valgus surgery. Foot Ankle Int 36:1078–1083.  https://doi.org/10.1177/1071100715581449 CrossRefGoogle Scholar
  24. 24.
    Milczarek MA, Milczarek JJ, Tomasik B et al (2017) Being overweight has limited effect on SCARF osteotomy outcome for hallux valgus correction. Int Orthop 41:765–772.  https://doi.org/10.1007/s00264-017-3419-0 CrossRefGoogle Scholar
  25. 25.
    Stewart MS, Bettin CC, Ramsey MT et al (2016) Effect of obesity on outcomes of forefoot surgery. Foot Ankle Int 37:483–487.  https://doi.org/10.1177/1071100715624209 CrossRefGoogle Scholar

Copyright information

© SICOT aisbl 2018

Authors and Affiliations

  • Daniel Pérez-Prieto
    • 1
    Email author
  • Marta Cuenca
    • 1
  • Raquel Marí
    • 1
  • Raquel Martínez
    • 1
  • Gemma González
    • 1
  • Alberto Ginés
    • 1
  1. 1.Orthopedic DepartmentHospital del Mar–Universitat Autònoma de BarcelonaBarcelonaSpain

Personalised recommendations