Cargando…
Functional and radiographic outcomes of hallux valgus correction by mini-invasive surgery with Reverdin-Isham and Akin percutaneous osteotomies: a longitudinal prospective study with a 48-month follow-up
BACKGROUND: Minimally invasive surgery (MIS) represents one of the most innovative surgical treatments of hallux valgus (HV). However, long-term outcomes still remain a matter of discussion within the orthopaedic community. The purpose of this longitudinal prospective study was to evaluate radiograp...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2016
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5139107/ https://www.ncbi.nlm.nih.gov/pubmed/27919259 http://dx.doi.org/10.1186/s13018-016-0491-x |
_version_ | 1782472184664424448 |
---|---|
author | Biz, Carlo Fosser, Michele Dalmau-Pastor, Miki Corradin, Marco Rodà, Maria Grazia Aldegheri, Roberto Ruggieri, Pietro |
author_facet | Biz, Carlo Fosser, Michele Dalmau-Pastor, Miki Corradin, Marco Rodà, Maria Grazia Aldegheri, Roberto Ruggieri, Pietro |
author_sort | Biz, Carlo |
collection | PubMed |
description | BACKGROUND: Minimally invasive surgery (MIS) represents one of the most innovative surgical treatments of hallux valgus (HV). However, long-term outcomes still remain a matter of discussion within the orthopaedic community. The purpose of this longitudinal prospective study was to evaluate radiographic and functional outcomes in patients with mild-to-severe HV who underwent Reverdin-Isham and Akin percutaneous osteotomy, following exostosectomy and lateral release. METHODS: Eighty patients with mild-to-severe symptomatic HV were treated by MIS. Clinical evaluation was assessed preoperatively, as well as at 3 and 12 months after surgery and at final follow-up of 48 months, using the American Orthopaedic Foot and Ankle Society (AOFAS) hallux grading system. Patient satisfaction and complications were recorded. Computer-assisted measurement of antero-posterior radiographs was taken preoperatively, as well as at 3 and 12 months after surgery and at 48-month follow-up, analysing the intermetatarsal angle (IMA), the hallux valgus angle (HVA), the distal metatarsal articular angle (DMAA) and the tibial sesamoid position. Also, the bridging bone/callus formation was evaluated at the different radiographic follow-ups, while the articular surface congruency and the metatarsal index were calculated only preoperatively and at the last follow-up. Patient satisfaction was assessed using the visual analogue score (VAS). Statistical analysis was carried out using the paired t test. Statistical significance was set at p < 0.05. RESULTS: The mean AOFAS score was 87.15 points at the final follow-up of 48 months, and the VAS score was 8.35/10. The post-operative radiographic assessments showed a statistically significant improvement compared with preoperative values. The mean corrections of each angular value at the last follow-up were as follows: IMA 3.90°, HVA 12.50°, DMAA 4.72° and a tibial sesamoid position of 1.10. The articular surface was congruent in 77 (96.25%) cases and incongruent only in 3 (3.75%). The complete healing of the osteotomies was achieved in all series at 3-month follow-up. However, the results obtained in the correction of the severe HV deformities were less encouraging. CONCLUSIONS: Minimally invasive surgery with Reverdin-Isham and Akin percutaneous osteotomy, in combination with previous exostosectomy and subsequent lateral soft-tissue release, is a safe, effective and reliable procedure for correction of mild-to-moderate HV. However, it requires a long learning curve because of the inherent difficulty of the mixed different surgical procedures. TRIAL REGISTRATION: ClinicalTrials.gov PRS Protocol Registration and Results System: NCT02886221 |
format | Online Article Text |
id | pubmed-5139107 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-51391072016-12-15 Functional and radiographic outcomes of hallux valgus correction by mini-invasive surgery with Reverdin-Isham and Akin percutaneous osteotomies: a longitudinal prospective study with a 48-month follow-up Biz, Carlo Fosser, Michele Dalmau-Pastor, Miki Corradin, Marco Rodà, Maria Grazia Aldegheri, Roberto Ruggieri, Pietro J Orthop Surg Res Research Article BACKGROUND: Minimally invasive surgery (MIS) represents one of the most innovative surgical treatments of hallux valgus (HV). However, long-term outcomes still remain a matter of discussion within the orthopaedic community. The purpose of this longitudinal prospective study was to evaluate radiographic and functional outcomes in patients with mild-to-severe HV who underwent Reverdin-Isham and Akin percutaneous osteotomy, following exostosectomy and lateral release. METHODS: Eighty patients with mild-to-severe symptomatic HV were treated by MIS. Clinical evaluation was assessed preoperatively, as well as at 3 and 12 months after surgery and at final follow-up of 48 months, using the American Orthopaedic Foot and Ankle Society (AOFAS) hallux grading system. Patient satisfaction and complications were recorded. Computer-assisted measurement of antero-posterior radiographs was taken preoperatively, as well as at 3 and 12 months after surgery and at 48-month follow-up, analysing the intermetatarsal angle (IMA), the hallux valgus angle (HVA), the distal metatarsal articular angle (DMAA) and the tibial sesamoid position. Also, the bridging bone/callus formation was evaluated at the different radiographic follow-ups, while the articular surface congruency and the metatarsal index were calculated only preoperatively and at the last follow-up. Patient satisfaction was assessed using the visual analogue score (VAS). Statistical analysis was carried out using the paired t test. Statistical significance was set at p < 0.05. RESULTS: The mean AOFAS score was 87.15 points at the final follow-up of 48 months, and the VAS score was 8.35/10. The post-operative radiographic assessments showed a statistically significant improvement compared with preoperative values. The mean corrections of each angular value at the last follow-up were as follows: IMA 3.90°, HVA 12.50°, DMAA 4.72° and a tibial sesamoid position of 1.10. The articular surface was congruent in 77 (96.25%) cases and incongruent only in 3 (3.75%). The complete healing of the osteotomies was achieved in all series at 3-month follow-up. However, the results obtained in the correction of the severe HV deformities were less encouraging. CONCLUSIONS: Minimally invasive surgery with Reverdin-Isham and Akin percutaneous osteotomy, in combination with previous exostosectomy and subsequent lateral soft-tissue release, is a safe, effective and reliable procedure for correction of mild-to-moderate HV. However, it requires a long learning curve because of the inherent difficulty of the mixed different surgical procedures. TRIAL REGISTRATION: ClinicalTrials.gov PRS Protocol Registration and Results System: NCT02886221 BioMed Central 2016-12-05 /pmc/articles/PMC5139107/ /pubmed/27919259 http://dx.doi.org/10.1186/s13018-016-0491-x Text en © The Author(s). 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Biz, Carlo Fosser, Michele Dalmau-Pastor, Miki Corradin, Marco Rodà, Maria Grazia Aldegheri, Roberto Ruggieri, Pietro Functional and radiographic outcomes of hallux valgus correction by mini-invasive surgery with Reverdin-Isham and Akin percutaneous osteotomies: a longitudinal prospective study with a 48-month follow-up |
title | Functional and radiographic outcomes of hallux valgus correction by mini-invasive surgery with Reverdin-Isham and Akin percutaneous osteotomies: a longitudinal prospective study with a 48-month follow-up |
title_full | Functional and radiographic outcomes of hallux valgus correction by mini-invasive surgery with Reverdin-Isham and Akin percutaneous osteotomies: a longitudinal prospective study with a 48-month follow-up |
title_fullStr | Functional and radiographic outcomes of hallux valgus correction by mini-invasive surgery with Reverdin-Isham and Akin percutaneous osteotomies: a longitudinal prospective study with a 48-month follow-up |
title_full_unstemmed | Functional and radiographic outcomes of hallux valgus correction by mini-invasive surgery with Reverdin-Isham and Akin percutaneous osteotomies: a longitudinal prospective study with a 48-month follow-up |
title_short | Functional and radiographic outcomes of hallux valgus correction by mini-invasive surgery with Reverdin-Isham and Akin percutaneous osteotomies: a longitudinal prospective study with a 48-month follow-up |
title_sort | functional and radiographic outcomes of hallux valgus correction by mini-invasive surgery with reverdin-isham and akin percutaneous osteotomies: a longitudinal prospective study with a 48-month follow-up |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5139107/ https://www.ncbi.nlm.nih.gov/pubmed/27919259 http://dx.doi.org/10.1186/s13018-016-0491-x |
work_keys_str_mv | AT bizcarlo functionalandradiographicoutcomesofhalluxvalguscorrectionbyminiinvasivesurgerywithreverdinishamandakinpercutaneousosteotomiesalongitudinalprospectivestudywitha48monthfollowup AT fossermichele functionalandradiographicoutcomesofhalluxvalguscorrectionbyminiinvasivesurgerywithreverdinishamandakinpercutaneousosteotomiesalongitudinalprospectivestudywitha48monthfollowup AT dalmaupastormiki functionalandradiographicoutcomesofhalluxvalguscorrectionbyminiinvasivesurgerywithreverdinishamandakinpercutaneousosteotomiesalongitudinalprospectivestudywitha48monthfollowup AT corradinmarco functionalandradiographicoutcomesofhalluxvalguscorrectionbyminiinvasivesurgerywithreverdinishamandakinpercutaneousosteotomiesalongitudinalprospectivestudywitha48monthfollowup AT rodamariagrazia functionalandradiographicoutcomesofhalluxvalguscorrectionbyminiinvasivesurgerywithreverdinishamandakinpercutaneousosteotomiesalongitudinalprospectivestudywitha48monthfollowup AT aldegheriroberto functionalandradiographicoutcomesofhalluxvalguscorrectionbyminiinvasivesurgerywithreverdinishamandakinpercutaneousosteotomiesalongitudinalprospectivestudywitha48monthfollowup AT ruggieripietro functionalandradiographicoutcomesofhalluxvalguscorrectionbyminiinvasivesurgerywithreverdinishamandakinpercutaneousosteotomiesalongitudinalprospectivestudywitha48monthfollowup |