Hallux Valgus and Pes Cavus Are Highly Heritable

INTRODUCTION: Although genetic factors are frequently cited as risk factors for hallux valgus (HAV) and pes cavus (PC), only one study has provided evidence that genetics play a role in foot disorders. The primary aim of this study was to estimate the heritability of HAV and PC utilizing genetic data collected in the large, community-based Framingham Foot Study. METHODS: Framingham Foot Study participants (n=2179) were genotyped and prospectively examined for common foot disorders by a trained examiner using a validated foot exam. Heritability of HAV and PC was analyzed by a standard quantitative genetic variance-components model implemented in the Sequential Oligogenic Linkage Analysis Routines (SOLAR) package. RESULTS: Mean age was 66y (range 39-99y) and the prevalence of HAV and PC was 31% and 7% respectively. HAV heritability was 39% for women and 38% for men but was significantly higher for adult participants <60y (HAV heritability = 89%). PC heritability was 68% for women and 20% for men but was significantly higher for participants <60y [PC heritability = 99% (women) and 63% (men)]. CONCLUSIONS: This is the first large community-based study to estimate the genetic effect of HAV and PC. Our results indicate that HAV and PC are highly heritable, especially for adults ages 39-to 60y. Therefore, we conclude that a positive family history for HAV or PC is a relevant risk factor. Future studies should assess effective preventive treatment strategies, especially in younger adults, that minimize the impact of these foot disorders in patients identified as high risk.