167 Efficacy of Minimally Invasive Surgery on Hallux Valgus – a Systematic Review and Meta-Analysis

Abstract

Aim The aim of this study is to evaluate the effect of minimally invasive surgery over open surgery for hallux valgus with respect to surgical outcomes and patient reported outcomes. Method Medline Complete, PubMed, Cochrane Library, Scopus, SAGE Journals and gray literature were searched. Primary outcomes focused on hallux valgus angle, intermetatarsal angle, distal metatarsal articular angle. Secondary Outcomes included the American Foot & Ankle Society Score (AOFAS), as well as Pain on a Visual Analogue Scale(VAS), patient satisfaction, complications, SF-36 questionnaire and Manchester Oxford Foot Questionnaire (MOXFQ). Results & Conclusions 8 randomized trials and 7 cohort studies were identified (n=907). Radiological outcomes between similar techniques were found to have no significant difference pre-post operatively at final follow up. Visual analogue scale scores were found to be significantly lower in the MIS groups compared to open techniques (MICA v Scarf) in the short term at Day 1 (P<0.00001) MD= -1.96 95% CI: -2.28, -1.65; I2 = 0%; Week 2 (P=0.001) MD= -1.40; 95% CI: -2.26, -0.54; and Week 6 (P=0.005) MD= -1.50; 95% CI: -2.55, -0.45. There was no statistical difference at 6 months (P=0.46) MD= -0.16; 95% CI: -0.59, 0.27; I2 = 0%; or final follow up (6 m to >24m) (P=0.94) MD= -0.02; 95% CI: -0.44, 0.41; I2 = 0%.). There were no statistically important differences between post-operative AOFAS scores across comparisons, whereas AOFAS mean difference was found to be significantly higher in Open Scarf vs MICA (P = 0.003); MD=-5.54; 95% CI: -9.19, -1.88. I2 = 0%.