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Third-Generation Minimally Invasive Chevron Akin Osteotomy for Hallux Valgus.
Foot Ankle Int 2019; :1071100719874360FA

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+Show Affiliations

Department of Trauma & Orthopaedics, Croydon University Hospital, Croydon, UK.Department of Trauma & Orthopaedics, Croydon University Hospital, Croydon, UK.Department of Trauma & Orthopaedics, Croydon University Hospital, Croydon, UK.Department of Trauma & Orthopaedics, Croydon University Hospital, Croydon, UK.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31522534

Citation

Holme, Thomas J., et al. "Third-Generation Minimally Invasive Chevron Akin Osteotomy for Hallux Valgus." Foot & Ankle International, 2019, p. 1071100719874360.
Holme TJ, Sivaloganathan SS, Patel B, et al. Third-Generation Minimally Invasive Chevron Akin Osteotomy for Hallux Valgus. Foot Ankle Int. 2019.
Holme, T. J., Sivaloganathan, S. S., Patel, B., & Kunasingam, K. (2019). Third-Generation Minimally Invasive Chevron Akin Osteotomy for Hallux Valgus. Foot & Ankle International, p. 1071100719874360. doi:10.1177/1071100719874360.
Holme TJ, et al. Third-Generation Minimally Invasive Chevron Akin Osteotomy for Hallux Valgus. Foot Ankle Int. 2019 Sep 14;1071100719874360. PubMed PMID: 31522534.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Third-Generation Minimally Invasive Chevron Akin Osteotomy for Hallux Valgus. AU - Holme,Thomas J, AU - Sivaloganathan,Sivan S, AU - Patel,Beejal, AU - Kunasingam,Kumar, Y1 - 2019/09/14/ PY - 2019/9/17/entrez KW - MICA KW - MIS KW - keyhole bunion surgery KW - minimally invasive hallux valgus SP - 1071100719874360 EP - 1071100719874360 JF - Foot & ankle international JO - Foot Ankle Int N2 - 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. SN - 1944-7876 UR - https://www.unboundmedicine.com/medline/citation/31522534/Third-Generation_Minimally_Invasive_Chevron_Akin_Osteotomy_for_Hallux_Valgus L2 - http://journals.sagepub.com/doi/full/10.1177/1071100719874360?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -