Minimally invasive surgery for severe hallux valgus in 106 feet

Lewis, Thomas; Ray, Robbie; Gordon, David

doi:10.1016/j.fas.2022.01.010

Cited by 19 publications

(26 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Studies of third-generation MIS techniques reported significant improvement in clinical and radiologic outcomes, with a low radiographic recurrence rate. 5,21,24,28,29,31-33,35,42,45,50 Comparative systematic reviews of open and percutaneous techniques suggest no significant difference in radiographic correction, pain, and function at 6 months. 15,23…”

Section: Introductionmentioning

confidence: 99%

“…Recently, there has been increased interest and research on third-generation MIS techniques and the applicability of these techniques to different types of deformity. 5,21,24,28,29,31-33,35,42,45,50 Studies have suggested the radiographic deformity correction that can be achieved using certain MIS techniques in severe deformities is potentially greater than reported in a range of open techniques with similar complication rates. 7,12,31,35…”

Section: Introductionmentioning

confidence: 99%

“…5,21,24,28,29,31-33,35,42,45,50 Studies have suggested the radiographic deformity correction that can be achieved using certain MIS techniques in severe deformities is potentially greater than reported in a range of open techniques with similar complication rates. 7,12,31,35…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Fourth-Generation Minimally Invasive Hallux Valgus Surgery With Metaphyseal Extra-Articular Transverse and Akin Osteotomy (META): 12 Month Clinical and Radiologic Results

et al. 2023

View full text Add to dashboard Cite

Background: Fourth-generation minimally invasive surgery (MIS) includes the multiplanar rotational deformity correction achieved through manipulation of an extra-articular distal first metatarsal osteotomy that is held with rigid fixation using 2 fully threaded screws, of which one must be bicortical to provide rotational and biomechanical stability. The aim of this study is to report the clinical and radiologic outcomes of an evolved fourth-generation MIS hallux valgus technique. Methods: A prospective single-surgeon series of consecutive patients undergoing fourth-generation MIS was performed using a distal transverse osteotomy with a minimum 12-month follow-up. The primary outcome was the Manchester-Oxford Foot Questionnaire (MOXFQ), a validated clinical patient-reported outcome measure (PROM). Secondary outcomes included radiographic deformity correction, clinical assessment, and EuroQol-5D-5L PROMs. Results: Between September 2019 and June 2021, 50 feet underwent fourth-generation MIS. The mean age was 55.8±15.3 years with a mean follow-up of 1.4 years. Preoperative and minimum 12-month primary outcome data were available for 100% of feet. There was a significant improvement in all MOXFQ domain scores, with the index domain improving from 53.4 to 13.1 ( P < .001). There was a significant improvement ( P < .001) in hallux valgus angle (32.7 to 7.9 degrees), intermetatarsal angle (14.0 to 4.2 degrees) and distal metatarsal articular angle (18.5 to 5.6 degrees). There was a significant improvement in general health-related quality of life EQ-5D-5L index and EQ-VAS scores ( P < .05). Conclusion: The fourth-generation MIS technique is a safe and effective approach to hallux valgus deformity correction with significant improvement in clinical and radiographic outcomes. Level of Evidence: Level IV, prospective case series.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Fourth-Generation Minimally Invasive Hallux Valgus Surgery With Metaphyseal Extra-Articular Transverse and Akin Osteotomy (META): 12 Month Clinical and Radiologic Results

et al. 2023

View full text Add to dashboard Cite

show abstract

“…Lewis et al 5 prospectively reported on 106 consecutive feet (78 patients) that underwent third-generation minimally invasive chevron and Akin (MICA) osteotomies for severe hallux valgus. In the 86 feet (81.1%) with a minimum 2-year follow-up, there was significant improvement in all MOXFQ domains.…”

Section: Forefootmentioning

confidence: 99%

What’s New in Foot and Ankle Surgery

Hembree

Tarka

Pasternack

et al. 2023

Journal of Bone and Joint Surgery

View full text Add to dashboard Cite

“…48 There are now a number of methodologically robust observational studies with large sample sizes investigating third-generation MIS that demonstrate significant improvement in both clinical and radiologic outcomes across a range of deformity severities. 27,[29][30][31]34 Comparative studies and systematic reviews suggest that clinical outcomes following third-generation MIS techniques are comparable to traditional open techniques, and have reduced pain scores, smaller scars, and potentially quicker recovery. 3,14,16,32,33,43 The major limitation of the existing third-generation MIS hallux valgus literature is the length of clinical and radiographic follow-up.…”

Section: Introductionmentioning

confidence: 99%

Five-Year Follow-up of Third-Generation Percutaneous Chevron and Akin Osteotomies (PECA) for Hallux Valgus

et al. 2023

View full text Add to dashboard Cite

Background: Recent large studies of third-generation minimally invasive hallux valgus surgery (MIS) have demonstrated significant improvement in clinical and radiologic outcomes. It remains unknown whether these clinical and radiologic outcomes are maintained in the medium to long term. The aim of this study was to investigate the minimum 5-year clinical and radiologic outcomes following third-generation MIS hallux valgus surgery in the hands of a high-volume MIS surgeon. Methods: A retrospective observational single highly experienced MIS surgeon case series of consecutive patients undergoing primary isolated third-generation percutaneous chevron and Akin osteotomies (PECA) for hallux valgus with a minimum 60-month clinical and radiographic follow-up. Primary outcome was radiographic assessment of the hallux valgus angle (HVA) and intermetatarsal angle (IMA) preoperatively, 6 months, and ≥60 months following PECA. Secondary outcomes included the Manchester-Oxford Foot Questionnaire, patient satisfaction, EuroQol-5D visual analog scale and the visual analog scale for pain. Results: Between 2012 and 2014, 126 consecutive feet underwent isolated third-generation PECA, with complete data available for 78 (61.9%) feet. The median follow-up was 65.0 (IQR 64-69; range 60-88) months. There was a significant improvement in radiographic deformity correction; the median IMA improved from 12.0 degrees (interquartile range [IQR]: 10.8-14.2) to 6.0 degrees (IQR: 4.2-7.3) ( P < .001), and the median HVA improved from 27.2 degrees (IQR: 20.6-34.4) to 7.2 degrees (IQR: 3.4-11.6). Median MOXFQ Index score at ≥60-month follow-up was 2.3 (IQR: 0.0-7.8). The radiographic recurrence rate (defined as HVA >15 degrees) was 7.7% at final follow-up. The complication rate was 4.8%. Conclusion: Radiologic deformity correction for the 78 feet we were able to follow that had third-generation PECA performed by a single highly experienced MIS surgeon was found to be maintained at a mean follow-up of average 66.8 months, with a radiographic recurrence rate of 7.7%. Clinical PROMs and patient satisfaction levels were high and comparable to other third-generation studies with shorter duration of follow-up. Level of Evidence: Level IV, retrospective cohort study.

show abstract

Minimally invasive surgery for severe hallux valgus in 106 feet

Cited by 19 publications

References 40 publications

Fourth-Generation Minimally Invasive Hallux Valgus Surgery With Metaphyseal Extra-Articular Transverse and Akin Osteotomy (META): 12 Month Clinical and Radiologic Results

Fourth-Generation Minimally Invasive Hallux Valgus Surgery With Metaphyseal Extra-Articular Transverse and Akin Osteotomy (META): 12 Month Clinical and Radiologic Results

What’s New in Foot and Ankle Surgery

Five-Year Follow-up of Third-Generation Percutaneous Chevron and Akin Osteotomies (PECA) for Hallux Valgus

Contact Info

Product

Resources

About