Minimally invasive surgery for hallux valgus: a systematic review of current surgical techniques.
- 230 Downloads
The aim of this study was to systematically evaluate the available literature on minimally invasive surgical (MIS) treatment for hallux valgus and to provide an overview of the different surgical techniques.
A systematic review of the literature available in MEDLINE, EMBASE, and the Cochrane database was performed including studies from January 2001 to 1 January 2018. The radiological outcomes (hallux valgus angle (HVA), intermetatarsal angle (IMA)), complication rates, and clinical outcome scores were evaluated. The MINORS scale was used to assess the methodological quality of included articles.
Of 278 reviewed articles, 23 met the inclusion criteria. The included studies reported on the results of 2279 procedures in 1762 patients. The surgical techniques were divided into five categories: the Bosch technique, MIS Chevron-Akin, Reverdin-Isham procedure, Endolog system, and techniques involving distal soft tissue release and fixation. Results regarding radiological correction, clinical outcomes, and complication rate varied widely.
The studies included were of too little level of evidence to allow for data pooling or meta-analysis. There were too few studies on each surgical technique category to assess whether one is more effective than the rest. However, there is some evidence that the Chevron and Akin showed the most potential for improvement of the HVA and the Endolog for the IMA. An overall complication rate of 13% was obtained among all included studies. Appropriately powered randomized controlled trials, utilizing validated outcome measures, blinded assessors, and long-term follow up are needed to assess the efficacy of MIS techniques.
KeywordsHallux valgus Percutaneous Minimally invasive surgical procedures Minimum incision Arthroscopy Osteotomy Metatarsal
The authors would like to thank Dr. Lluis Jover at Biostatistics Unit of University of Barcelona for his valuable support during the preparation of this review.
- 1.Ferrari J, Higgins JP, Prior TD., (2004) Interventions for treating hallux valgus (abductovalgus) and bunions. Cochrane Database Syst Rev, CD000964Google Scholar
- 3.Tsikopoulos K, Papaioannou P, Kitridis D, Mavridis D, Georgiannos D (2018) Proximal versus distal metatarsal osteotomies for moderate to severe hallux valgus deformity: a systematic review and meta-analysis of clinical and radiological outcomes. Int Orthop 42:1853–1863CrossRefPubMedCentralGoogle Scholar
- 4.Kaufmann G, Dammerer D, Heyenbrock F, Braito M, Moertlbauer L, Liebensteiner M. (2018) Minimally invasive versus open chevron osteotomy for hallux valgus correction: a randomized controlled trial. Int Orthop. 1–8. https://doi.org/10.1007/s00264-018-4006-8
- 7.Laffenêtre O, Golano P, GRECMIP (2010) Introduction to foot and ankle minimally invasive surgery. E-mémoires de l’Académie Nationale de Chirurgie 9:52–60Google Scholar
- 13.Mathavan G, Gaskell L, Pillai A, Thinesh VS, Pravin DC (2015) Minimal invasive hallux valgus surgery: myth or magic. A systematic review. Orthop Rheumatol Open Access J 1(1):555551Google Scholar
- 14.NICE. National Institute for Health and Clinical Excellence. (2010) Interventional procedure overview of surgical correction of hallux valgus using minimal access techniques. Interventional procedure guidance. https://www.nice.org.uk/guidance/ipg332/documents/surgical-correction-of-hallux-valgus-using-minimal-access-techniques-overview2
- 35.Biz C, Fosser M, Dalmau-Pastor M, Corradin M, Rodà MG, Aldegheri R, Ruggieri P (2016) Functional and radiographic outcomes of hallux valgus correction by mini-invasive surgery with Reverdin-Isham and Akin percutaneous osteotomies: a longitudinal prospective study with a 48-month follow-up. J Orthop Surg Res 11:157CrossRefPubMedCentralGoogle Scholar
- 38.Lai MC, Rikhraj IS, Woo YL, Yeo W, Ng YCS, Koo K (2017) Clinical and radiological outcomes comparing percutaneous Chevron-Akin osteotomies vs open scarf-akin osteotomies for hallux valgus. Foot Ankle Int 1:1071100717745282Google Scholar