Radiological and Functional Outcomes of Fourth-Generation MIS Hallux Valgus Correction (META) in an Indian Population.

Abstract

Over 150 variants of conventional open operative techniques have been described for primary correction of HV. MIS in the treatment of hallux valgus deformity has gained increasing popularity since the 1990s with the advantages of less soft tissue dissection, reduced surgical time, and a faster recovery time. The most recent fourth-generation MIS hallux valgus is known as META (metaphyseal extra-articular transverse and Akin) having an additional benefit of correction of the rotational pronation deformity. This article describes the outcome of META in an Indian population. 50 feet were operated using fourth-generation MIS (META) for HV correction and assessed based on their functional (AOFAS-Hallux and VAS) and radiological (HVA, IMA, and DMMA) parameters at 6 months post-surgery. At 6 months, AOFAS-hallux score significantly improved from 62.1 ± 12.34 to 94.56 ± 5.58 post-operatively, VAS decreased conspicuously from 5.78 ± 2.35 to 1.22 ± 1.03, HVA decreased from 29.4 ± 7.36 to 6.1 ± 5.24, and IMA improved from 15.76 ± 1.6 to 5.12 ± 2.49. DMMA declined from 16.36 ± 4.30 to 5.23 ± 5.75. P values of all the variables suggested high significance. This is the first and the largest case series to be published regarding the outcome of fourth-generation MIS hallux valgus correction (META) in India. META helps in decreasing the chances of recurrence. Although it has a steeper learning curve, but it has the advantages of lesser operative time, minimal blood loss, better cosmesis, lower chances of infection, lesser pain, and quicker rehabilitation of the patient. Complications can be prevented and their incidence can be minimized with practice.