Third-Generation Minimally Invasive Chevron Akin Osteotomy for Hallux Valgus.

Abstract

BACKGROUND:

Multiple operative techniques have been developed for hallux valgus with varying success. The most recent developments in minimally invasive surgery have evolved into the third-generation minimally invasive chevron Akin (MICA) osteotomy. Good results have been shown from originator centers, but this is one of the first series from a nonoriginator center, and the first to use a validated patient-reported outcome measure.

METHODS:

Forty consecutive patients undergoing third-generation MICA for hallux valgus were included. Primary outcome measures included Manchester-Oxford Foot Questionnaire (MOXFQ) and American Orthopaedic Foot & Ankle Society (AOFAS) scores and Coughlin satisfaction rates at 12 months. Secondary outcome measures included radiographic parameters, complications, and recurrence rates.

RESULTS:

At 12 months, the MOXFQ score improved from 58 to 10 and the AOFAS score improved from 48 to 93, with 70% of patients reporting excellent outcomes and 30% good ones. Two cases started as mild, 29 cases as moderate, and 9 cases as severe as defined by radiographic criteria. Hallux valgus angles improved from 32 degrees to 12 degrees, and intermetatarsal angles improved from 13 degrees to 7 degrees. There were 4 cases of Akin screw removal for soft tissue irritation. There were no other complications, including recurrence.

CONCLUSION:

The third-generation MICA technique was a safe and effective approach to treating hallux valgus. Further research should focus on long-term outcomes and comparative data with other commonly performed operative techniques.

LEVEL OF EVIDENCE:

Level IV, case series.

• Authors: Thomas J Holme, Sivan S Sivaloganathan, Beejal Patel, Kumar Kunasingam
• Journal: Foot & ankle international (Foot Ankle Int) Vol. 41 Issue 1 Pg. 50-56 (01 2020) ISSN: 1944-7876 [Electronic] United States
• PMID: 31522534 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Female
• Hallux Valgus (surgery)
• Humans
• Male
• Middle Aged
• Minimally Invasive Surgical Procedures
• Osteotomy (methods)
• Patient Reported Outcome Measures
• Patient Satisfaction
• Young Adult