Third-Generation Minimally Invasive Chevron Akin Osteotomy for Hallux Valgus: Three-Year Outcomes,Indian Journal of Orthopaedics

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Third-Generation Minimally Invasive Chevron Akin Osteotomy for Hallux Valgus: Three-Year Outcomes
Indian Journal of Orthopaedics ( IF 1.1 ) Pub Date : 2023-06-05 , DOI: 10.1007/s43465-023-00917-3
Azka Yousaf ₁ , Jawaad Saleem ₁ , Lena Al-Hilfi ₁ , Kumar Kunasingam ₁

Affiliation

Introduction

Numerous minimally invasive techniques have been developed for Hallux Valgus in recent years. Third-generation Minimally Invasive Chevron Akin (MICA) osteotomy has shown promising early results, but longer-term follow-up is required to assess whether patient clinical and radiological improvement is sustained. This cohort study presents three-year follow-up outcomes for patients of a single surgeon case series.

Methods

Thirty-three patients underwent third-generation MICA surgery between 2017 and 2018. Patient clinical-reported outcome measures included American Orthopaedic Foot & Ankle Society (AOFAS), Manchester-Oxford Foot Questionnaire (MOXFQ) scores, and Coughlin satisfaction. Radiographic outcomes were evaluated after a period of three years using hallux valgus angle (HVA) and inter-metatarsal angle (IMA), and compared to pre- and early post-operative outcomes.

Results

At 36 months, mean AOFAS scores improved from 48.2 to 95.6, mean MOXFQ scores improved from 57.6 to 6.7. Using the Coughlin scale, 81.8% of patients rated their outcome as ‘Excellent’ and 18.2% as ‘Good’. Radiographic outcomes showed HVA and mean IMA decreased from 34.6 degrees to 16.0 degrees and from 13.1 to 6.1, respectively at 36 months.

Conclusion

Third-generation MICA demonstrates promising patient satisfaction scores post-operatively, and we have shown these improvements are sustained over a minimum three-year follow-up period.

Level of Evidence

Level IV, case series.

中文翻译：

第三代微创 Chevron Akin 截骨术治疗拇外翻：三年结果

介绍

近年来，针对拇趾外翻开发了多种微创技术。第三代微创 Chevron Akin (MICA) 截骨术已显示出有希望的早期结果，但需要更长期的随访来评估患者临床和放射学改善是否持续。该队列研究展示了单个外科医生病例系列患者的三年随访结果。

方法

2017 年至 2018 年间，33 名患者接受了第三代 MICA 手术。患者临床报告的结果指标包括美国骨科足踝协会 (AOFAS)、曼彻斯特-牛津足部问卷 (MOXFQ) 评分和 Coughlin 满意度。三年后使用拇外翻角（HVA）和跖骨间角（IMA）评估放射学结果，并与术前和术后早期结果进行比较。

结果

36 个月时，平均 AOFAS 分数从 48.2 提高到 95.6，平均 MOXFQ 分数从 57.6 提高到 6.7。使用 Coughlin 量表，81.8% 的患者将其结果评为“优秀”，18.2% 的患者将其评为“良好”。放射学结果显示，36 个月时，HVA 和平均 IMA 分别从 34.6 度下降至 16.0 度，从 13.1 下降至 6.1。