The effect of hallux valgus open and percutaneous surgery on AOFAS scale: a systematic review and meta-analysis

ObjectiveThe treatment effect of orthoses for hallux valgus (HV) is unclear with little interventional studies, the design involves multiple complex factors, and therefore a systematic analysis with meta-analysis is necessary. The objective of this systematic review and meta-analysis is to determine whether current foot orthoses are effective in treating HV.DesignSystematic review with meta-analysis.Data sourcesElectronic databases (PubMed, Scopus, Cinahl and Medline) are searched up to February 2020.Eligibility criteria for selecting studiesInterventional studies with content focus on HV orthosis design and any of the outcomes related to effectiveness for treating HV are included. The standardised mean differences are calculated. The risk of bias in included studies is assessed using the Cochrane Collaboration’s risk of bias tools.ResultsIn total, 2066 articles are identified. Among them, nine are selected and quality rated, and data are extracted and closely examined. A meta-analysis is conducted, where appropriate. The main causes of potential bias are missing outcome data and outcome measurement error. The results show that orthosis with a toe separator has the best effect of correcting the HV angle (standardised mean difference: 0.50, 95% CI: 0.189 to 0.803).ConclusionThe orthoses design with a toe separator or an element that allows for the foot anatomic alignment is critical for reducing the HV angle and relieving foot pain. The results contribute to a better selection of treatment for patients.PROSPERO registration numberCRD42021260403.

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Prevalence of hallux valgus in the general population: a systematic review and meta-analysis

Journal of Foot and Ankle Research ◽

10.1186/1757-1146-3-21 ◽

2010 ◽

Vol 3 (1) ◽

Cited By ~ 281

Author(s):

Sheree Nix ◽

Michelle Smith ◽

Bill Vicenzino

Keyword(s):

Systematic Review ◽

General Population ◽

Hallux Valgus ◽

Meta Analysis

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Adjusted Indirect and Mixed Comparisons of Conservative Treatments for Hallux Valgus: A Systematic Review and Network Meta-Analysis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18073841 ◽

2021 ◽

Vol 18 (7) ◽

pp. 3841

Author(s):

Jianhua Ying ◽

Yining Xu ◽

Bíró István ◽

Feng Ren

Keyword(s):

Systematic Review ◽

Hallux Valgus ◽

Meta Analysis ◽

Valgus Deformity ◽

Subjective Feeling ◽

Dry Needling ◽

High Quality ◽

Intermetatarsal Angle ◽

Hallux Valgus Deformity ◽

Long Term Treatment

Background: Hallux valgus (HV) deformity is a common, potentially debilitating deformity. And evidence with high-quality for the conservative treatments of HV deformity is still required.; AIMS: To compare the effects of different conservative treatments for hallux valgus deformity by using the method of network meta-analysis.; Study Design: A systematic review and network meta-analysis of randomized controlled trials identified by searching PubMed, EMBASE, MEDLINE, OVID, and CINAHL. The included studies should have the characteristics that: (1) participants with hallux valgus deformity of any age (2) conservative treatments (3) Reported the hallux valgus (HVA), the intermetatarsal angle (IMA), the score of the Visual Analog Scale, and the score of Foot Function Index.; Results: 11 studies were included in this review. The agreement between reviewers reached a kappa value of 0.75. The results of the network meta-analysis showed that a combination of exercise and toe separator, night splints, and dry needling are most likely to be the best choice for reducing the hallux valgus angle (HVA) and intermetatarsal angle, and toe separators (with or without exercise), dry needling, and manipulation (with or without ice treatment) have advantages in improving the subjective feeling of patients.; Conclusions: Multi-disciplinary conservative treatments have a great potential for hallux valgus deformity. More research with high-quality is needed to give a comprehensive and reasonable scheme of a holistic and long-term treatment protocol.

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TL 18144 - Percutaneous chevron/akin (PECA) versus open scarf/akin (SA) osteotomy treatment in hallux valgus

Scientific Journal of the Foot & Ankle ◽

10.30795/scijfootankle.2019.v13.1071 ◽

2019 ◽

Vol 13 (Supl 1) ◽

pp. 92S

Author(s):

Kelly Cristina Stéfani ◽

Gabriel Ferraz Ferreira ◽

Vinícius Quadros Borges ◽

Leonardo Vinicius De Matos Moraes

Keyword(s):

Systematic Review ◽

Hallux Valgus ◽

Meta Analysis ◽

Perioperative Period ◽

Fixed Effect Model ◽

Cochrane Library ◽

Percutaneous Technique ◽

Radiographic Outcomes ◽

Effect Model ◽

The Cochrane Library

Introduction: The surgical treatment of hallux valgus presents several techniques described in the literature. Recently, the percutaneous technique has appeared as a less invasive option in the correction of the deformity and is increasingly used by surgeons. Methods: A meta-analysis was performed using studies discovered by the systematic review of articles included in electronic databases (Medline, Scopus, Embase and the Cochrane Library) until June 2018 (Systematic Review Registry PROSPERO: CRD42018096613). A pooling analysis was synthesized from clinical outcomes such as the visual analogue scale of pain (VAS) and AOFAS score, radiographic outcomes and evaluation of complications. Results: Two studies, including 137 feet with a hallux valgus diagnosis were added to the analysis, comparing open surgery using the Scarf and Akin (SA) technique versus percutaneous Chevron and Akin (PECA). In the synthesis of the results, pain in the perioperative period was lower in the PECA group, with a reduction of 1.68 points in the fixed effect model (95% CI = -2.09 a -1.27, p < 0.01, i2 = 87%, t2 = 0.60). There were no differences between techniques in the radiographic results or in the risk of complications. The PECA technique demonstrated a longer radioscopy time compared with SA. Conclusion: Use of the PECA method to correct hallux valgus compared with the open SA technique demonstrated less pain in the perioperative period, a similar potential for radiographic correction and an equal risk of complications, with a longer radioscopy time.

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Mobility of the First Ray in Patients With or Without Hallux Valgus Deformity: Systematic Review and Meta-Analysis

The Journal of Foot & Ankle Surgery ◽

10.1053/j.jfas.2017.05.021 ◽

2017 ◽

Vol 56 (5) ◽

pp. 1070-1075 ◽

Cited By ~ 16

Author(s):

Naohiro Shibuya ◽

Thomas S. Roukis ◽

Daniel C. Jupiter

Keyword(s):

Systematic Review ◽

Hallux Valgus ◽

Meta Analysis ◽

Valgus Deformity ◽

Hallux Valgus Deformity ◽

First Ray

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Percutaneous Chevron/Akin (Peca) Versus Open Scarf/Akin (Sa) Osteotomies Treatment in Hallux Valgus: A Systematic Review and Meta-Analysis of 137 Feet

Foot & Ankle Orthopaedics ◽

10.1177/2473011419s00171 ◽

2019 ◽

Vol 4 (4) ◽

pp. 2473011419S0017

Author(s):

Kelly Cristina Stéfani ◽

Leonardo Moraes ◽

Gabriel Ferraz Ferreira ◽

Vinicius Borges

Keyword(s):

Systematic Review ◽

Hallux Valgus ◽

Meta Analysis ◽

Perioperative Period ◽

Fixed Effect Model ◽

Pooled Analysis ◽

Cochrane Library ◽

Percutaneous Technique ◽

Radiographic Outcomes ◽

Fixed Model

Category: Bunion Introduction/Purpose: The surgical treatment of hallux valgus presents several techniques described in the literature. Recently the percutaneous technique appeared as a less invasive option in the correction of the deformity and more and more used by the surgeons. Methods: The meta-analysis was performed through studies found from the systematic review of articles included in electronic databases (Medline, Scopus, Embase and the Cochrane Library) until June 2018 (Systematic Review Registry PROSPERO: CRD42018096613). The pooled analysis was synthesized from clinical outcomes such as visual analogue scale of pain and AOFAS score, radiographic outcomes and evaluation of complications, with 95% confidence interval. The pooled data were weighted using the fixed model effect. Results: Two studies, including 137 feet with hallux valgus diagnosis were added in the analysis, comparing open surgery using the Scarf and Akin (SA) technique versus the percutaneous Chevron and Akin (PECA). In the synthesis of the result, pain in the perioperative period was lower in the PECA group, with a reduction of 1.96 points in the fixed effect model (95% CI = -2.28 to - 1.65, p = 0.53, i2 = 0%, t2 = 0), without presenting differences between techniques in the radiographic result, nor in the risk of complications. The PECA technique demonstrated longer radioscopy time when compared to SA. Conclusion: The use of the percutaneous method (PECA) to correct hallux valgus when compared to the open technique (SA) demonstrated less pain in the perioperative period, similar potential of radiographic correction and an equal risk of complications, with a longer radioscopy time.

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