Jorge Javier Del Vecchio1,2,3, Mauricio Esteban Ghioldi4, Lucas Nicolás Chemes4, Eric Daniel Dealbera4, Julieta Brue5, Miki Dalmau-Pastor6,7. 1. Head Foot and Ankle Section, Orthopaedics Department, Fundación Favaloro, Hospital Universitario, Solis 461, CP 1078, Ciudad Autónoma de Buenos Aires (CABA), Argentina. javierdv@mac.com. 2. Department of Kinesiology and Physiatry, Universidad Favaloro, Av. Entre Ríos 495, CABA, CP 1079, Argentina. javierdv@mac.com. 3. Minimally Invasive Foot and Ankle Society (MIFAS By Grecmip), 2 Rue Georges Negrevergne, 33700, Merignac, France. javierdv@mac.com. 4. Foot and Ankle Section, Fundación Favaloro, Hospital Universitario, Buenos Aires, Argentina. 5. Foot and Ankle and Limb Salvage Surgery Fellowship, Fundación Favaloro, Hospital Universitario, Buenos Aires, Argentina. 6. Minimally Invasive Foot and Ankle Society (MIFAS By Grecmip), 2 Rue Georges Negrevergne, 33700, Merignac, France. 7. Human Anatomy Unit, Department of Pathology and Experimental Therapeutics, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
Abstract
PURPOSE: Treatment for hallux valgus (HV) remains challenging. Third-generation percutaneous procedures try to reproduce chevron-type osteotomies to replicate their benefits, such as intrinsic stability and reproducibility. We report the first results using a percutaneous, intra-articular, chevron osteotomy (PeICO) technique that mimics the classic intra-articular open chevron procedure, associated with a percutaneous adductor tendon release (PATR) for the treatment of mild-to-moderate HV. METHODS: From May 2015 to October 2018, a total of consecutive 114 feet (74 patients) were included. Primary outcome measures included radiographic (hallux valgus and intermetatarsal angles) and clinical parameters such as visual analog scale (VAS), FAAM Activities of Daily Living (ADL), and FAAM Sport, AOFAS Score, and MOXFQ, preoperatively and at final follow-up (Minimum 18 months). A patient satisfaction survey was also performed. Pronation and length of the first metatarsal were also assessed. Secondary outcomes included fluoroscopic time, length of surgery, complications, recurrence, and re-operation rates. RESULTS: At 24.09 months on average, the AOFAS score improved from 52.1 points preoperatively to 91.1 (p < 0.001) at the latest follow-up. VAS decreased from 6.3 to 1. Also, FAAM ALD, FAAM Sport, and MOXFQ showed statistically significant differences (p < 0.001) when comparing pre-operative and post-operative periods. Patients found the procedure to be excellent in 82% and very good in 13.5% of cases. Our global complication and re-operation rates were 5.26% and 3.5% (screw removal), respectively. CONCLUSION: PeICO combined with PATR proved to be a safe, reliable, and effective technique for the correction of mild-to-moderate HV deformity.
PURPOSE: Treatment for hallux valgus (HV) remains challenging. Third-generation percutaneous procedures try to reproduce chevron-type osteotomies to replicate their benefits, such as intrinsic stability and reproducibility. We report the first results using a percutaneous, intra-articular, chevron osteotomy (PeICO) technique that mimics the classic intra-articular open chevron procedure, associated with a percutaneous adductor tendon release (PATR) for the treatment of mild-to-moderate HV. METHODS: From May 2015 to October 2018, a total of consecutive 114 feet (74 patients) were included. Primary outcome measures included radiographic (hallux valgus and intermetatarsal angles) and clinical parameters such as visual analog scale (VAS), FAAM Activities of Daily Living (ADL), and FAAM Sport, AOFAS Score, and MOXFQ, preoperatively and at final follow-up (Minimum 18 months). A patient satisfaction survey was also performed. Pronation and length of the first metatarsal were also assessed. Secondary outcomes included fluoroscopic time, length of surgery, complications, recurrence, and re-operation rates. RESULTS: At 24.09 months on average, the AOFAS score improved from 52.1 points preoperatively to 91.1 (p < 0.001) at the latest follow-up. VAS decreased from 6.3 to 1. Also, FAAM ALD, FAAM Sport, and MOXFQ showed statistically significant differences (p < 0.001) when comparing pre-operative and post-operative periods. Patients found the procedure to be excellent in 82% and very good in 13.5% of cases. Our global complication and re-operation rates were 5.26% and 3.5% (screw removal), respectively. CONCLUSION: PeICO combined with PATR proved to be a safe, reliable, and effective technique for the correction of mild-to-moderate HV deformity.
Authors: Alexej Barg; Joshua R Harmer; Angela P Presson; Chong Zhang; Mellanye Lackey; Charles L Saltzman Journal: J Bone Joint Surg Am Date: 2018-09-19 Impact factor: 5.284
Authors: Mun Chun Lai; Inderjeet Singh Rikhraj; Yew Lok Woo; William Yeo; Yung Chuan Sean Ng; Kevin Koo Journal: Foot Ankle Int Date: 2017-12-14 Impact factor: 2.827
Authors: Jorge Javier Del Vecchio; Mauricio Esteban Ghioldi; Anuar Emanuel Uzair; Lucas Nicolás Chemes; María Cristina Manzanares-Céspedes; Eric Daniel Dealbera; Miki Dalmau-Pastor Journal: Foot Ankle Int Date: 2019-01-28 Impact factor: 2.827