Radiographic Outcomes from Minimally Invasive Bunion Surgery in Australia: A Retrospective Cohort Analysis of 169 Procedures Using the Minimally Invasive Chevron Akin (MICA) Procedure

Andrew F. KnoxDivision of Podiatric Medicine & Surgery, School of Allied Health, The University of Western Australia, Crawley, Western Australia, Australia.
Australasian College of Podiatric Surgeons, Melbourne, Victoria, Australia.

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Nicholas J. StuddertAustralasian College of Podiatric Surgeons, Melbourne, Victoria, Australia.

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Natasha R. Knox
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Abstract

Background: The emergence of minimally invasive techniques in foot and ankle surgery has aimed to reduce iatrogenic tissue insult by utilising the smallest possible incision area to achieve maximum correction of pathological structures. The objective of this study was to assess whether adequate hallux valgus correction can be achieved via the minimally invasive chevron akin (MICA) procedure.

Methods: A retrospective analysis was conducted for a single-surgeon case series of 169 MICA procedures between June 2018 and June 2021 in Australia. Radiographic parameters were evaluated independently by two researchers using 1-2 intermetatarsal angle (1-2 IMA) and hallux valgus angle (HVA) as key measures of procedural outcome.

Results: 95% of participant-operations resulted in normal 1-2 IMA and HVA being obtained post-operatively in a cohort that largely consisted of moderate hallux valgus deformities; 1-2 IMA Reduction: 6.38° ± 3.24 (95% CI 5.89 to 6.87) and HVA Reduction: 20.17° ± 7.69 (95% CI 19.01 to 21.33).

Conclusion: The results of this study help to further strengthen support for the use of minimally invasive bunion surgery as a primary treatment approach in mild to moderate hallux valgus.

Corresponding author: Andrew F. Knox, C/- 525 Stirling Highway, Cottesloe WA, Australia 6011. (E-mail: andrew.knox@perthpodiatricsurgery.com)