Advertisement

Minimally invasive surgery for hallux valgus: a systematic review of current surgical techniques.

  • Francesc Malagelada
  • Cyrus Sahirad
  • Miki Dalmau-Pastor
  • Jordi Vega
  • Rej Bhumbra
  • Maria Cristina Manzanares-Céspedes
  • Olivier Laffenêtre
Review Article
  • 172 Downloads

Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusions

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.

Keywords

Hallux valgus Percutaneous Minimally invasive surgical procedures Minimum incision Arthroscopy Osteotomy Metatarsal 

Notes

Acknowledgements

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.

References

  1. 1.
    Ferrari J, Higgins JP, Prior TD., (2004) Interventions for treating hallux valgus (abductovalgus) and bunions. Cochrane Database Syst Rev, CD000964Google Scholar
  2. 2.
    Dayton P, Sedberry S, Feilmeier M (2015) Complications of metatarsal suture techniques for bunion correction: a systematic review of the literature. J Foot Ankle Surg. 54:230–232CrossRefPubMedCentralGoogle Scholar
  3. 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. 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
  5. 5.
    Roukis TS (2009) Percutaneous and minimum incision metatarsal osteotomies: a systematic review. J Foot Ankle Surg 48:380–387CrossRefPubMedCentralGoogle Scholar
  6. 6.
    Maffulli N, Longo UG, Marinozzi A et al (2011) Hallux valgus: effectiveness and safety of minimally invasive surgery. A systematic review. Br Med Bull 9:149–167CrossRefGoogle Scholar
  7. 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
  8. 8.
    Lui TH, Chan KB, Chow HT et al (2008) Arthroscopy-assisted correction of hallux valgus deform- ity. Arthroscopy 24:875–880CrossRefPubMedCentralGoogle Scholar
  9. 9.
    Di Giorgio L, Touloupakis G, Simone S, Imparato L, Sodano L et al (2013) The Endolog system for moderate to severe hallux valgus. J Orthop Surg 21:47–50CrossRefGoogle Scholar
  10. 10.
    Lucas y Hernandez J, Golanó P, Roshan-Zamir S, Darcel V, Chauveaux D, Laffenêtre O. (2016) Treatment of moderate hallux valgus by percutaneous, extra-articular reverse-L Chevron (PERC) osteotomy. Bone Joint J 98-B:365–373CrossRefGoogle Scholar
  11. 11.
    Brogan K, Lindisfarne E, Akehurst H, Farook U, Shrier W, Palmer S (2016) Minimally invasive and open distal chevron osteotomy for mild to moderate hallux valgus. Foot Ankle Int. 37:1197–1204CrossRefPubMedCentralGoogle Scholar
  12. 12.
    Trnka HJ, Krenn S, Schuh R (2013) Minimally invasive hallux valgus surgery: a critical review of the evidence. Int Orthop 37(9):1731–1375CrossRefPubMedCentralGoogle Scholar
  13. 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. 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
  15. 15.
    Caravelli S, Mosca M, Massimi S, Costa GG, Lo Presti M, Fuiano M, Grassi A, Zaffagnini S (2017) Percutaneous treatment of hallux valgus: what’s the evidence? A systematic review. Musculoskelet Surg.  https://doi.org/10.1007/s12306-017-0512-x CrossRefPubMedCentralGoogle Scholar
  16. 16.
    Bia A, Guerra-Pinto F, Pereira BS, Corte-Real N, Oliva XM (2018) Percutaneous osteotomies in hallux valgus: a systematic review. J Foot Ankle Surg 57:123–130CrossRefPubMedCentralGoogle Scholar
  17. 17.
    Brogan K, Voller T, Gee C, Borbely T, Palmer S (2014) Third-generation minimally invasive correction of hallux valgus: technique and early outcomes. Int Orthop 38:2115–2121CrossRefPubMedCentralGoogle Scholar
  18. 18.
    Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J (2003) Methodological index for non-randomized studies (MINORS): development and validation of a new instrument. ANZ J Surg 73(9):712–716CrossRefGoogle Scholar
  19. 19.
    Moher D, Liberati A, Tetzlaff J, Altman DG (2010) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg 8(5):336–341CrossRefPubMedCentralGoogle Scholar
  20. 20.
    Magnan B, Pezzè L, Rossi N, Bartolozzi P (2005) Percutaneous distal metatarsal osteotomy for correction of hallux valgus. J Bone Joint Surg Am 87:1191–1199PubMedPubMedCentralGoogle Scholar
  21. 21.
    Lin YC, Cheng YM, Chang JK, Chen CH, Huang PJ (2009) Minimally invasive distal metatarsal osteotomy for mild to moderate hallux valgus deformity. Kaohsiung J Med Sci 25(8):431–437CrossRefPubMedCentralGoogle Scholar
  22. 22.
    Maffulli N, Longo UG, Oliva F, Denaro V, Coppola C (2009) Bosch osteotomy and scarf osteotomy for hallux valgus correction. Orthop Clin North Am 40:515–524CrossRefPubMedCentralGoogle Scholar
  23. 23.
    Siclari A, Decantis V (2009) Arthroscopic lateral release and percutaneous distal osteotomy for hallux valgus: a preliminary report. Foot Ankle Int 30:675–679CrossRefPubMedCentralGoogle Scholar
  24. 24.
    Bauer T, de Lavigne C, Biau D, De Prado M, Isham S, Laffenétre O (2009) Percutaneous hallux valgus surgery: a prospective multicenter study of 189 cases. Orthop Clin North Am 40:505–514CrossRefPubMedCentralGoogle Scholar
  25. 25.
    Enan A, Abo-Hegy M, Seif H (2010) Early results of distal metatarsal osteotomy through minimally invasive approach for mild-to- moderate hallux valgus. Acta Orthop Belg 76:526–535PubMedPubMedCentralGoogle Scholar
  26. 26.
    Tong CK, Ho YF (2012) Use of minimally invasive distal metatarsal osteotomy for correction of hallux valgus. J Orthop Trauma Rehabili 16:16–21CrossRefGoogle Scholar
  27. 27.
    Martínez-Nova A, Sánchez-Rodríguez R, Leal-Muro A, Pedrera-Zamorano JD (2011) Dynamic plantar pressure analysis and midterm outcomes in percutaneous correction for mild hallux valgus. J Orthop Res 29:1700–1706CrossRefPubMedCentralGoogle Scholar
  28. 28.
    Radwan YA, Mansour AM (2012) Percutaneous distal metatarsal osteotomy versus distal chevron osteotomy for correction of mild- to-moderate hallux valgus deformity. Arch Orthop Trauma Surg 132:1539–1546CrossRefPubMedCentralGoogle Scholar
  29. 29.
    Scala A, Vendettuoli D (2013) Modified minimal incision subcapital osteotomy for hallux valgus correction. Foot Ankle Spec 6:65–72CrossRefPubMedCentralGoogle Scholar
  30. 30.
    Giannini S, Cavallo M, Faldini C, Luciani D, Vannini F (2013) The SERI distal metatarsal osteotomy and scarf osteotomy provide similar correction of hallux valgus. Clin Orthop Relat Res 471:2305–2311CrossRefPubMedCentralGoogle Scholar
  31. 31.
    Gadek A, Liszka H (2013) Mini-invasive Mitchell-Kramer method in the operative treatment of hallux valgus deformity. Foot Ankle Int 34:865–869CrossRefPubMedCentralGoogle Scholar
  32. 32.
    Giannini S, Faldini C, Nanni M, Di Martino A, Luciani D, Vannini F (2013) A minimally invasive technique for surgical treatment of hallux valgus: simple, effective, rapid, inexpensive (SERI). Int Orthop 37(9):1805–1813CrossRefPubMedCentralGoogle Scholar
  33. 33.
    Gicquel T, Fraisse B, Marleix S, Chapuis M, Violas P (2013) Percutaneous hallux valgus surgery in children: short-term outcomes of 33 cases. Orthop Traumatol Surg Res 99:433–439CrossRefPubMedCentralGoogle Scholar
  34. 34.
    Biz C, Corradin M, Petretta I, Aldegheri R (2015) Endolog technique for correction of hallux valgus: a prospective study of 30 patients with 4-years follow-up. J Orthop Surg Res 10:102–115CrossRefPubMedCentralGoogle Scholar
  35. 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
  36. 36.
    Di Giorgio L, Sodano L, Touloupakis G, De Meo D, Marcellini L (2016) Reverdin-Isham osteotomy versus Endolog system for correction of moderate hallux valgus deformity: a randomized controlled trial. Clin Ter 167(6):e150–e154PubMedPubMedCentralGoogle Scholar
  37. 37.
    Jowett CRJ, Bedi HS (2017) Preliminary results and learning curve of the minimally invasive Chevron akin operation for hallux Valgus. J Foot Ankle Surg. 56:445–452CrossRefPubMedCentralGoogle Scholar
  38. 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
  39. 39.
    Arias-Martín I, Reina-Bueno M, Munuera-Martínez PV (2018) Effectiveness of custom-made foot orthoses for treating forefoot pain: a systematic review. Int Orthop 42:1865–1875CrossRefPubMedCentralGoogle Scholar
  40. 40.
    Kaufmann G, Handle M, Liebensteiner M, Braito M, Dammerer D (2018) Percutaneous minimally invasive Akin osteotomy in hallux valgus interphalangeus: a case series. Int Orthop 42:117–124CrossRefPubMedCentralGoogle Scholar
  41. 41.
    Milczarek MA, Milczarek JJ, Tomasik B, Łaganowski P, Nowak K, Domżalski M (2017) Being overweight has limited effect on SCARF osteotomy outcome for hallux valgus correction. Int Orthop 41:765–772CrossRefPubMedCentralGoogle Scholar
  42. 42.
    Faldini C, Nanni M, Traina F, Fabbri D, Borghi R, Giannini S (2016) Surgical treatment of hallux valgus associated with flexible flatfoot during growing age. Int Orthop 40:737–743CrossRefPubMedCentralGoogle Scholar

Copyright information

© SICOT aisbl 2018

Authors and Affiliations

  • Francesc Malagelada
    • 1
    • 2
  • Cyrus Sahirad
    • 3
  • Miki Dalmau-Pastor
    • 2
    • 4
  • Jordi Vega
    • 2
    • 5
  • Rej Bhumbra
    • 1
  • Maria Cristina Manzanares-Céspedes
    • 2
  • Olivier Laffenêtre
    • 6
  1. 1.Orthopaedic and Trauma Surgery, Royal London HospitalBarts Health NHS TrustLondonUK
  2. 2.Laboratory of Arthroscopic and Surgical Anatomy, Department of Pathology and Experimental Therapeutics (Human Anatomy and Embryology Unit)University of BarcelonaBarcelonaSpain
  3. 3.University of SheffieldSheffieldUK
  4. 4.Manresa Health Science SchoolUniversity of Vic-Central University of CataloniaBarcelonaSpain
  5. 5.Foot and Ankle UnitHospital Quiron BarcelonaBarcelonaSpain
  6. 6.Clinique Geoffroy St HilaireParisFrance

Personalised recommendations