Endoscopy-Assisted Hallux Valgus Correction

NewsBot · Feb 20, 2018

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Endoscopy-Assisted Hallux Valgus Correction Provides Sustainable Long-Term >10-Year Outcomes.
Ling SKK, Lui TH
Arthroscopy. 2018 Feb 15. pii: S0749-8063(17)31521-9. doi: 10.1016/j.arthro.2017.12.017.

PURPOSE:
This study aims to review the long-term efficacy of the endoscopy-assisted distal soft-tissue procedure (EDSTP) and to see whether operative correction can be maintained for >10 years.

METHODS:
All hallux valgus cases undergoing EDSTP from 2000 to 2006 were recruited. Preoperative, postoperative, and 10-year follow-up x-rays were analyzed. A pain score from the preoperative and >10-year follow-up was recorded. The American Orthopaedic Foot and Ankle Society (AOFAS) hallux score and Foot and Ankle Outcome Score (FAOS) were measured at the >10-year follow-up.

RESULTS:
A total of 85 cases met the inclusion criteria with an EDSTP performed between January 2000 and December 2006 and had a follow-up of >10 years. Hallux valgus angle corrected from 25.8° to 11.2° (P < .001), 1,2 intermetatarsal angle (1,2 IMA) improved from 13.5° to 9.5° (P < .001), and the tibial sesamoid position changed from 4 to 1 (P < .001). Pain improved from preoperative 6.5/10 to 0.5/10 (P < .001). AOFAS score was 93.5/100 at >10-year follow-up, and the FAOS was good in all 5 subcategories (range, 72.6-89.3).

CONCLUSIONS:
Our results show that the EDSTP has good early postoperative results that are maintained for >10 years. It provides good long-term radiological correction, in addition to lasting pain relief and great foot function, using only 5 incisions.
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NewsBot · Jun 2, 2018

Editorial Commentary: The Great Endoscopically Assisted Bunion Surgery That Will Never Become Popular—I Will Not Try This at Home
David Thordarson, M.D.
Arthroscopy: The Journal of Arthroscopic & Related Surgery
Volume 34, Issue 6, June 2018, Pages 1964–1965

Bunion surgery almost invariably involves osteotomies and open incisions. Recently, some surgeons have been performing minimally invasive osteotomies with less morbidity, more rapid healing, and good results. These surgeries are heavily technique dependent, and other surgeons cannot always reproduce these results. Endoscopically assisted bunion surgery yielded excellent results at 10 years in this study but will likely never be used commonly because of the extremely demanding surgical technique and requisite learning curve.
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