CME OnDemand: 2022 AOFAS Annual Meeting-Comparative Analysis of Hallux Valgus Surgical Techniques: A Systematic Review

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This systematic review compared the radiologic outcomes and quality-of-life outcomes of three surgical techniques for hallux valgus correction: Proximal Chevron Osteotomy (PCO), Lapidus Arthrodesis (LA), and Minimally Invasive Surgery (MIS). The review included studies published between 1990 and 2022, and data was collected from PubMed, OvidSP, and Scopus electronic databases.<br /><br />The radiologic outcomes were measured using the hallux valgus angle (HVA) and intermetatarsal angle (IMA), while the quality-of-life outcomes were assessed using the American Orthopedic Foot and Ankle Score (AOFAS). The review aimed to compare these outcomes between the different surgical techniques.<br /><br />The findings revealed that PCO had higher HVA and IMA differences compared to LA, indicating better radiologic correction. LA, on the other hand, had lower postoperative HVA and IMA angles compared to MIS, suggesting more physiologic correction. The postoperative AOFAS means were similar between MIS and LA.<br /><br />The review concluded that radiologic outcomes may be a better guide for decision-making than quality-of-life outcomes when choosing between the surgical techniques. MIS was also considered a safer alternative due to less scarring and joint stiffness.<br /><br />The study included a comprehensive list of studies with corresponding means for each outcome, including PCO, LA, and MIS procedures. The inclusion criteria required studies to report radiologic correction, fixation methods used, and patient subpopulations with hallux valgus fixation.<br /><br />In conclusion, more research is needed to determine the ideal procedure and explore better techniques for hallux valgus correction. However, based on the available data, patients had similar quality-of-life outcomes post-surgery, suggesting that radiologic outcomes may play a more significant role in decision-making. MIS may be preferable due to shorter recovery time and similar quality-of-life outcomes compared to LA.

Asset Subtitle

Atish Amin, Shahrukh R. Ali, BS, Mayurkumar S. Patel, Tyler B. Nsekpong, BS, Brian J. Beasley, BS, Vinod K. Panchbhavi, MD, FACS, Daniel Jupiter, PhD

Keywords

systematic review

radiologic outcomes

quality-of-life outcomes

surgical techniques

hallux valgus correction

Proximal Chevron Osteotomy

Lapidus Arthrodesis

Minimally Invasive Surgery

decision-making

recovery time