Journal article
Recurrence Rates With Longer-Term Follow-up After Hallux Valgus Surgical Treatment With Distal Metatarsal Osteotomies: A Systematic Review and Meta-analysis
Foot & ankle international, Vol.44(3), pp.210-222
03/01/2023
DOI: 10.1177/10711007231152487
PMID: 36859795
Abstract
BACKGROUND Recurrence of hallux valgus (HV) following corrective surgery is a frequent concern. A recent systematic review estimated recurrence of HV in only 4.9%, which may be an underestimation, as most included studies had short- to mid-term follow-up. The purpose of this systematic review and meta-analysis was to assess long-term outcomes of distal osteotomies of the first metatarsal (M1) to treat HV without inflammatory disease or degenerative arthritis, and to assess HV recurrence rates reported in studies that had a minimum follow-up of 5 years. METHODS This systematic review conforms to the PRISMA guidelines. The authors conducted a search using PubMed, Embase, and Cochrane Central Register of Controlled Trials databases. Studies that report outcomes of distal osteotomies of the M1 for noninflammatory and nondegenerative HV at a minimum follow-up of 5 years. RESULTS We found 17 eligible studies comprising 18 data sets, reporting outcomes of 4 categories of osteotomies: Chevron, Mitchell, Bösch, and "others." The HV recurrence rate was 64% considering the threshold of >15 degrees hallux valgus angle (HVA), 10% having >20 degrees, and 5% having >25 degrees. CONCLUSION At a minimum of 5 years following distal osteotomies of the M1, the mean weighted postoperative HVA was significantly higher for Mitchell osteotomies compared with the 3 other osteotomies reviewed. There were otherwise no significant differences in recurrence rates using the 3 HVA thresholds, or intermetatarsal angle among any of the surgical techniques reported in 2 or more studies. The pooled HV recurrence rates considering the various thresholds of HVA were as follows: 64% having >15 degrees, 10% having >20 degrees, and 5% having >25 degrees. The recurrence rates in the long term for all categories of surgical procedures suggest that better understanding of pathogenesis and prognosis of HV is required before modifying or introducing new surgical techniques. LEVEL OF EVIDENCE Level IV, meta-analysis.
Details
- Title: Subtitle
- Recurrence Rates With Longer-Term Follow-up After Hallux Valgus Surgical Treatment With Distal Metatarsal Osteotomies: A Systematic Review and Meta-analysis
- Creators
- Matthieu Lalevee - Université de Rouen NormandieCesar de Cesar Netto - Roy J. and Lucille A. Carver College of MedicineDaniel Boublil - Groupe Elsan, Clinique du Parc, Lyon, France.Jean-Yves Coillard - Groupe Elsan, Clinique du Parc, Lyon, France.
- Resource Type
- Journal article
- Publication Details
- Foot & ankle international, Vol.44(3), pp.210-222
- DOI
- 10.1177/10711007231152487
- PMID
- 36859795
- ISSN
- 1071-1007
- eISSN
- 1944-7876
- Grant note
- name: Elsan
- Language
- English
- Date published
- 03/01/2023
- Academic Unit
- Orthopedics and Rehabilitation
- Record Identifier
- 9984375355102771
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