Minimally invasive bunionectomy may successfully treat severe hallux valgus deformity
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CHARLOTTE, N.C. — Third-generation minimally invasive chevron and akin osteotomy demonstrated significant improvements in clinical outcomes and deformity correction in patients with severe hallux valgus, according to presented results.
“There has been increasing interest in minimally invasive (MIS) hallux valgus surgery, particularly in the United States, after the past several years; however, small studies have only demonstrated effectiveness with patient-reported outcome measures (PROMs),” David J. Gordon, MD, MB BCh, FRCS(Orth), MRCSEd, said in his presentation at the American Orthopaedic Foot & Ankle Society Annual Meeting.
In their prospective, observational single-surgeon study, Gordon and colleagues analyzed 78 patients (n = 106 consecutive feet) who underwent primary third-generation minimally invasive chevron and akin osteotomy (MICA) with screw fixation for severe hallux valgus between September 2014 and May 2018. Outcome measures included PROMs, Manchester-Oxford Foot Questionnaire (MOXFQ), radiographic deformity correction, complications and VAS pain scale.
According to the abstract, preoperative and postoperative radiographic data were available for all 106 feet at 2 years after surgery. Following surgery, mean intermetatarsal angle improved from 18.2° to 6.3°, while mean hallux valgus angle improved from 45.3° to 10.9°.
PROMs and MOXFQ data were available for 86 feet (81.1%) at 2 years after surgery. In those remaining patients, MOXFQ pain scores improved from 39.2 to 7.5; walking scores improved from 38.2 to 5.9; and standing and social interaction scores improved from 48.6 to 5.5.
“[MICA] has demonstrated its ability to correct large radiographic deformities successfully in terms of functional outcomes, which are excellent at the 2-year stage,” Gordon said. “Further long-term studies, as well as comparative studies, would be useful.”
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Gordon DJ, et al. Minimally invasive surgery for severe hallux valgus with 2-year minimum follow-up in 106 feet. Presented at: American Orthopaedic Foot & Ankle Society Annual Meeting. Sept. 22 - Sept. 25, 2021; Charlotte, N.C.
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