Percutaneous Chevron Akin (Peca) Osteotomy for Treatment of Hallux Valgus Deformity: The Long- Term Results

Category: Bunion Introduction/Purpose: Little is known about the long-term results of percutaneous hallux valgus correction, particularly the recurrence rate and factors leading to recurrence. Methods: We retrospectively reviewed a single surgeon consecutive series of percutaneous chevron and akin o...

Full description

Bibliographic Details
Main Authors: Peter W. Robinson, Robbie Ray, Thomas A. Goff, Paul M. Dearden, Clare Watt, Margaret Smith, Peter Lam MBBS, FAOrthA, FRACS(Orth)
Format: Article
Language:English
Published: SAGE Publishing 2020-10-01
Series:Foot & Ankle Orthopaedics
Online Access:https://doi.org/10.1177/2473011420S00074
_version_ 1819205306106773504
author Peter W. Robinson
Robbie Ray
Thomas A. Goff
Paul M. Dearden
Clare Watt
Margaret Smith
Peter Lam MBBS, FAOrthA, FRACS(Orth)
author_facet Peter W. Robinson
Robbie Ray
Thomas A. Goff
Paul M. Dearden
Clare Watt
Margaret Smith
Peter Lam MBBS, FAOrthA, FRACS(Orth)
author_sort Peter W. Robinson
collection DOAJ
description Category: Bunion Introduction/Purpose: Little is known about the long-term results of percutaneous hallux valgus correction, particularly the recurrence rate and factors leading to recurrence. Methods: We retrospectively reviewed a single surgeon consecutive series of percutaneous chevron and akin osteotomies (PECA) performed between 2012-14 on 127 feet in 86 patients. Mean age was 52+-13 years at surgery and mean follow up (FU) was 69+-7 months. Patient reported outcome measures (PROMs) were completed by 65 patients (MOXFQ, VAS pain (0-100)) and Likert satisfaction scale by 86 patients. Pre-operative, 6 month and final follow up weight bearing radiographs were available for 68 feet. Radiological parameters measured were the hallux valgus angle (HVA) and 1-2 intermetatarsal angle (IMA). The data was normally distributed and presented as mean+-SD. Paired t-test was used to compare pre- and post-operative angles. Ordinal logistic regression was used to test for significant dependent variables on PROMs. Results: Mean MOXFQ was 10+-16 and mean VAS pain was 6+-13 out of 100 at a mean FU of 69+-7 months. 99% (85/86) patients were highly satisfied or satisfied. Mean HVA improved from 28.3+-8.1º to 8.4+-5.6º at final FU (p<0.001). No clinically relevant difference in HVA was seen between 6 months and final FU. Mean IMA improved from 12.7+-2.9º to 6.2+-2.7º at final FU (p<0.001). 2.9% (2/68) had an HVA >20º at final FU, these both started with a pre-operative HVA >40°. Pre-operative HVA >40º was significantly more likely to have an HVA >20º at final FU than those with pre-operative HVA <40º (22% vs 0%, p<0.001). There were 5 re-operations for removal of screws. 1 foot had hallux varus, but was still satisfied. Conclusion: The 5 year results for PECA hallux valgus correction show high levels of patient satisfaction, function and pain relief, with low complication and re-operation rates. Radiological correction is maintained at long term FU.
first_indexed 2024-12-23T04:49:36Z
format Article
id doaj.art-4b458b5045b54f7fb5e5547fac063779
institution Directory Open Access Journal
issn 2473-0114
language English
last_indexed 2024-12-23T04:49:36Z
publishDate 2020-10-01
publisher SAGE Publishing
record_format Article
series Foot & Ankle Orthopaedics
spelling doaj.art-4b458b5045b54f7fb5e5547fac0637792022-12-21T17:59:29ZengSAGE PublishingFoot & Ankle Orthopaedics2473-01142020-10-01510.1177/2473011420S00074Percutaneous Chevron Akin (Peca) Osteotomy for Treatment of Hallux Valgus Deformity: The Long- Term ResultsPeter W. RobinsonRobbie RayThomas A. GoffPaul M. DeardenClare WattMargaret SmithPeter Lam MBBS, FAOrthA, FRACS(Orth)Category: Bunion Introduction/Purpose: Little is known about the long-term results of percutaneous hallux valgus correction, particularly the recurrence rate and factors leading to recurrence. Methods: We retrospectively reviewed a single surgeon consecutive series of percutaneous chevron and akin osteotomies (PECA) performed between 2012-14 on 127 feet in 86 patients. Mean age was 52+-13 years at surgery and mean follow up (FU) was 69+-7 months. Patient reported outcome measures (PROMs) were completed by 65 patients (MOXFQ, VAS pain (0-100)) and Likert satisfaction scale by 86 patients. Pre-operative, 6 month and final follow up weight bearing radiographs were available for 68 feet. Radiological parameters measured were the hallux valgus angle (HVA) and 1-2 intermetatarsal angle (IMA). The data was normally distributed and presented as mean+-SD. Paired t-test was used to compare pre- and post-operative angles. Ordinal logistic regression was used to test for significant dependent variables on PROMs. Results: Mean MOXFQ was 10+-16 and mean VAS pain was 6+-13 out of 100 at a mean FU of 69+-7 months. 99% (85/86) patients were highly satisfied or satisfied. Mean HVA improved from 28.3+-8.1º to 8.4+-5.6º at final FU (p<0.001). No clinically relevant difference in HVA was seen between 6 months and final FU. Mean IMA improved from 12.7+-2.9º to 6.2+-2.7º at final FU (p<0.001). 2.9% (2/68) had an HVA >20º at final FU, these both started with a pre-operative HVA >40°. Pre-operative HVA >40º was significantly more likely to have an HVA >20º at final FU than those with pre-operative HVA <40º (22% vs 0%, p<0.001). There were 5 re-operations for removal of screws. 1 foot had hallux varus, but was still satisfied. Conclusion: The 5 year results for PECA hallux valgus correction show high levels of patient satisfaction, function and pain relief, with low complication and re-operation rates. Radiological correction is maintained at long term FU.https://doi.org/10.1177/2473011420S00074
spellingShingle Peter W. Robinson
Robbie Ray
Thomas A. Goff
Paul M. Dearden
Clare Watt
Margaret Smith
Peter Lam MBBS, FAOrthA, FRACS(Orth)
Percutaneous Chevron Akin (Peca) Osteotomy for Treatment of Hallux Valgus Deformity: The Long- Term Results
Foot & Ankle Orthopaedics
title Percutaneous Chevron Akin (Peca) Osteotomy for Treatment of Hallux Valgus Deformity: The Long- Term Results
title_full Percutaneous Chevron Akin (Peca) Osteotomy for Treatment of Hallux Valgus Deformity: The Long- Term Results
title_fullStr Percutaneous Chevron Akin (Peca) Osteotomy for Treatment of Hallux Valgus Deformity: The Long- Term Results
title_full_unstemmed Percutaneous Chevron Akin (Peca) Osteotomy for Treatment of Hallux Valgus Deformity: The Long- Term Results
title_short Percutaneous Chevron Akin (Peca) Osteotomy for Treatment of Hallux Valgus Deformity: The Long- Term Results
title_sort percutaneous chevron akin peca osteotomy for treatment of hallux valgus deformity the long term results
url https://doi.org/10.1177/2473011420S00074
work_keys_str_mv AT peterwrobinson percutaneouschevronakinpecaosteotomyfortreatmentofhalluxvalgusdeformitythelongtermresults
AT robbieray percutaneouschevronakinpecaosteotomyfortreatmentofhalluxvalgusdeformitythelongtermresults
AT thomasagoff percutaneouschevronakinpecaosteotomyfortreatmentofhalluxvalgusdeformitythelongtermresults
AT paulmdearden percutaneouschevronakinpecaosteotomyfortreatmentofhalluxvalgusdeformitythelongtermresults
AT clarewatt percutaneouschevronakinpecaosteotomyfortreatmentofhalluxvalgusdeformitythelongtermresults
AT margaretsmith percutaneouschevronakinpecaosteotomyfortreatmentofhalluxvalgusdeformitythelongtermresults
AT peterlammbbsfaorthafracsorth percutaneouschevronakinpecaosteotomyfortreatmentofhalluxvalgusdeformitythelongtermresults