A Multi-Dimensional Systematic Review of Minimally Invasive Bunion Surgery (MIBS)

Abstract

Background/Objectives: Hallux valgus, or a bunion, is a prevalent foot deformity associated with pain, limited mobility, and reduced quality of life. Surgical treatments include minimally invasive and traditional open techniques, but the optimal approach remains debated. This systematic review evaluates long-term outcomes, patient satisfaction, cost-effectiveness, the influence of patient-specific factors, rehabilitation protocols, and complication rates for these methods. Methods: A comprehensive search of PubMed, Medline, EMBASE, and Cochrane databases identified 22 studies published within the last 15 years, each with a minimum follow-up of 2 years. The systematic review adhered to PRISMA-ScR guidelines. Eligible studies reported on at least one of six key outcomes, and data were extracted on radiographic and clinical results, patient satisfaction, costs, rehabilitation timelines, and adverse events. Results: Minimally invasive bunion surgery (MIBS) showed faster recovery, higher patient satisfaction, and improved quality of life compared to open surgery. Radiographic outcomes, including hallux valgus and intermetatarsal angle correction, were durable, though outcomes were less consistent for severe deformities. MIBS was more cost-effective over time, owing to shorter operating times and faster recovery. Rehabilitation was accelerated, and wound complications were fewer with MIBS. However, open techniques remained preferable for severe deformities due to their reliability in complex corrections. Conclusions: MIBS offers substantial advantages for most patients undergoing bunion surgery, including faster recovery and fewer complications. However, open techniques may be better suited for severe deformities. Further research is needed to refine patient selection criteria and evaluate long-term outcomes in diverse populations.

Keywords: bunionectomy; complication rates; cost-effectiveness; hallux valgus; minimally invasive bunion surgery (MIBS); patient satisfaction; quality of life; radiographic correction; rehabilitation protocols; surgical outcomes.

Figure 1

PRISMA flow diagram depicting the process of literature selection and screening.

Figure 2

Dorsoplantar X-ray radiograph of the (1) hallux valgus angle (HVA) and (2) intermetatarsal angle (IMA); the HVA is measured as the angle formed between the longitudinal axis of the first metatarsal and the proximal phalanx of the hallux; the IMA is measured as the angle formed between the longitudinal axes of the first and second metatarsal bones.