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Outcomes and Surgical Strategies of Minimally Invasive Chevron/Akin Procedures
Steven K Neufeld1, Daniel Dean2, Syed Hussaini3
1The Orthopaedic Foot & Ankle Center, Falls Church, VA, USA.
Foot & Ankle International
|January 27, 2021
Summary
Minimally invasive chevron/Akin (MICA) surgery effectively corrects hallux valgus, showing significant improvements in pain, radiographic measures, and patient satisfaction with a low complication rate. The learning curve for this bunion correction technique was not a significant factor in outcomes.
Area of Science:
- Orthopedic Surgery
- Foot and Ankle Surgery
- Minimally Invasive Procedures
Background:
- Minimally invasive surgery (MIS) is gaining traction for bunion correction.
- Limited outcome data exist for third-generation minimally invasive chevron/Akin (MICA) techniques.
- This study addresses the need for comprehensive outcome data on MICA procedures.
Purpose of the Study:
- To evaluate radiographic outcomes, pain control, patient satisfaction, learning curve, and complication rates of MICA for hallux valgus.
- To describe strategies for avoiding perioperative complications in MIS bunionectomies.
Main Methods:
- Retrospective review of the first 94 consecutive MICA procedures performed by a single surgeon.
- Radiographic assessment of intermetatarsal angles (IMAs), hallux valgus angles (HVAs), and foot width.
- Evaluation of visual analog scale (VAS) pain scores and Coughlin satisfaction scores.
- Chart review for complication rates and statistical analysis using Student t test and chi-squared test.
Main Results:
- Significant improvements in IMA (12.6° to 5.7°) and HVA (26.8° to 10.3°) (P < .001).
- Reduced VAS pain scores from 5.2 to 2.4 within 1 week postoperatively (P < .001).
- High patient satisfaction (94% good/excellent) and low reoperation rate (5%), with no significant difference between early and late cases, indicating a manageable learning curve.
Conclusions:
- MICA osteotomy is a safe, reproducible technique for hallux valgus correction.
- The procedure offers rapid pain relief, significant deformity correction, and high patient satisfaction.
- The learning curve for MICA is manageable, with low complication rates observed.
