International Orthopaedics

, Volume 43, Issue 3, pp 625–637 | Cite as

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

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



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.


Hallux 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.


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Copyright information

© SICOT aisbl 2018

Authors and Affiliations

  • Francesc Malagelada
    • 1
    • 2
    Email author
  • 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

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