Preoperative and Postoperative Physical and Mechanical Rehabilitation Interventions in Hallux Valgus: A Systematic Review.

BACKGROUND

Approximately one-third of the adult population is affected by hallux valgus (HV). Surgical interventions are successful in reducing deformity; however, postoperative complications are common. There is growing evidence for prehabilitation and rehabilitation strategies in orthopaedic surgeries. However, the effectiveness of such strategies in HV surgery is currently unknown. This systematic review aimed to synthesise and determine the quality of evidence for the effectiveness of physical and mechanical prehabilitation and postoperative rehabilitation interventions for improving outcomes following HV surgery.

METHODS

Electronic databases: MEDLINE, Cochrane, CINAHL, Scopus, EMBASE and AMED were searched from inception until 19th May 2025, following the PRISMA guidelines. Randomised controlled trials were included to determine the effectiveness of preoperative and postoperative physical and mechanical therapies for improving outcomes in adults undergoing HV surgery. The evidence from individual studies was narratively synthesised, and data were not pooled because of the heterogeneity of interventions, methods and outcomes measures.

RESULTS

A total of 8166 titles and abstracts were screened, and 66 full-text papers were reviewed. Five studies met the eligibility criteria and were included in this review. No randomised controlled trials examined the effectiveness of eligible preoperative physical or mechanical interventions. Postoperative early weight-bearing, dynamic metatarsal splinting and transcutaneous ultrasound appeared to improve patient outcomes, whereas rigid-soled footwear improved patient satisfaction.

CONCLUSION

There is currently no evidence to support the effectiveness of preoperative physical and mechanical interventions for improving outcomes in HV surgery, and limited evidence supports postoperative interventions. Future trials should consider incorporating validated outcome measures.