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Meta-Analysis
. 2023 Jul;143(7):3997-4007.
doi: 10.1007/s00402-022-04693-x. Epub 2022 Nov 10.

Role of lateral soft tissue release in percutaneous hallux valgus surgery: a systematic review and meta-analysis of the literature

Antonio Izzo  1 , Salvatore Vallefuoco  1 , Morena Anna Basso  1 , Robbie Ray  2 , Francesco Smeraglia  1 , Andrea Cozzolino  1 , Massimo Mariconda  1 , Alessio Bernasconi  3
Affiliations
Meta-Analysis

Role of lateral soft tissue release in percutaneous hallux valgus surgery: a systematic review and meta-analysis of the literature

Antonio Izzo et al. Arch Orthop Trauma Surg. 2023 Jul.

Abstract

Background: It is unclear whether lateral soft tissue release (LSTR) is required as part of percutaneous hallux valgus (PHV) surgery. The primary aim of this systematic review was to assess whether LSTR reduces the risk of recurrence of hallux valgus deformity. The secondary aims were to assess if LSTR increases the risk of complications, improves the clinical outcome and leads to a greater radiographic correction.

Methods: We performed a PRISMA-compliant PROSPERO-registered systematic review, pooling clinical papers reporting results after PHV surgery into two categories (PHV with (Group 1, G1) and without LSTR (Group 2, G2)) and comparing them. Data regarding the study design, demographics, the surgical procedure and the clinical and radiological outcome were extracted and compared. Risk of bias was assessed using the modified Coleman Methodology Score (mCMS).

Results: Sixteen studies were selected (G1:594 feet; G2:553 feet). The pooled proportion of recurrence at a minimum 21-month follow-up (2%, 95%CI 0-3 vs 2%, 95%CI 0-5; p = 0.70) did not differ in the two groups. Similarly, the pooled proportion of complications (27%, 95%CI 17-38 vs 25%, 95%CI 12-37; p = 0.79) was similar. The pre- (p = 0.23) and post-operative AOFAS scores (p = 0.16), the pre-(HVA: p = 0.23) (IMA: p = 0.94) and post-operative radiological angles (HVA: p = 0.47) (IMA: p = 0.2) and the methodological quality of studies (p = 0.2) did not differ either between G1 and G2.

Conclusion: There is no evidence that LSTR performed during percutaneous HV surgery reduces the risk of recurrence of the deformity at a mean 4-year follow-up nor improves the clinical and radiological outcome.

Level of evidence: Level IV systematic review of Level I to IV studies.

Keywords: Hallux valgus; Lateral release; Meta-analysis; Minimally invasive; Percutaneous.

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Conflict of interest statement

On behalf of all authors, the corresponding author states that there is no conflict of interest related to this manuscript.

Figures

Fig. 1
Fig. 1
Flow chart for studies included in this systematic review
Fig. 2
Fig. 2
Meta-analysis of the proportion of recurrence of Hallux Valgus in patients that have undergone percutaneous Hallux Valgus surgery with and without lateral soft tissue release. Output generated by the Stata procedure metaprop
Fig. 3
Fig. 3
Meta-analysis of the proportion of complications in patients that underwent percutaneous Hallux Valgus surgery with and without lateral soft tissue release. Output generated by the Stata procedure metaprop
See this image and copyright information in PMC

References

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