Letter to the editor concerning "a cross-cultural adaptation and validation of the Chinese version of AOFAS hallux MTP-IP scale in patients with hallux valgus" by Wang et al. (2025).

Cross-cultural adaptation of clinical outcome measures is essential to ensure their applicability across diverse populations. The American Orthopaedic Foot and Ankle Society Hallux Metatarsophalangeal-Interphalangeal (AOFAS Hallux MTP-IP) scale is widely used to evaluate hallux valgus, yet cultural and linguistic adaptations are required to maintain validity. The recent study by Wang et al. contributes significantly to this field by providing a reliable and valid Chinese version of the AOFAS Hallux MTP-IP scale. Their findings confirm excellent reliability, internal consistency, and construct validity, which strengthen the evidence supporting the global use of this instrument. In this correspondence, we commend the authors' efforts and emphasize the broader importance of integrating validated scoring systems with functional outcomes. Recent research suggests that linking clinical scoring tools with objective assessments such as gait analysis and patient-reported measures enhances their clinical utility and allows for a more comprehensive evaluation of treatment outcomes. Furthermore, expanding validation efforts through multicenter studies and including diverse hallux deformities could address current limitations and provide stronger external validity. Collectively, such approaches will ensure that the AOFAS Hallux MTP-IP scale remains a robust and adaptable tool for both clinical practice and research in foot and ankle surgery.