Minimally invasive chevron bunionectomy, modified Lapidus procedure yield similar outcomes
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CHARLOTTE, N.C. — Compared with the modified Lapidus procedure, the minimally invasive chevron and Akin bunionectomy yields similar radiographic outcomes in patients matched for bunion severity, a presenter said.
“Our goal in this study was to compare clinical and radiographic outcomes of minimally invasive (MIS) chevron and bunionectomy to those of the modified Lapidus procedure,” Elizabeth Cody, MD, said in her presentation at the American Orthopaedic Foot & Ankle Society Annual Meeting.
Cody and colleagues retrospectively reviewed prospectively collected foot and ankle registry data on 41 patients who underwent the minimally invasive chevron and Akin procedure (MICA) and a matched cohort of 41 patients who underwent the modified Lapidus procedure. Outcome measures included preoperative and postoperative hallux valgus angles (HVA), intermetatarsal angles (IMA), tibial sesamoid position (SP), complications, revisions, patient-reported outcome measurement information scores (PROMIS) outcomes and patient satisfaction scores.
Overall, both groups achieved similar radiographic correction, Cody noted. Bunion recurrence, which was defined by a HVA of greater than or equal to 20°, occurred in one patient in the MICA cohort and in two patients in the Lapidus cohort. All three patients were asymptomatic, according to the abstract. Four patients in the MICA cohort and two patients in the Lapidus cohort underwent reoperation for removal of hardware. One patient in the MICA cohort required reoperation for wound closure, and one patient in the Lapidus cohort required a derotational proximal phalanx osteotomy, Cody said.
“We found that the MIS procedures used less OR time, but there were no significant differences in radiographic outcomes – contrary to our hypothesis, she added. “There were no significant differences in PROMIS outcomes or satisfaction,” Cody concluded.
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Cody E, et al. Clinical and radiographic outcomes of minimally invasive chevron bunionectomy compared to the modified Lapidus procedure. Presented at: American Orthopaedic Foot & Ankle Society Annual Meeting. Sept. 22 - Sept. 25, 2021; Charlotte, N.C.
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