Lalevee Matthieu, Saffarini Mo, van Rooij Floris, Nover Luca, Nogier Alexis, Beaudet Philippe
Department of Orthopedic Surgery, Rouen University Hospital, Rouen, France.
CETAPS UR3832, Research Center for Sports and Athletic Activities Transformations, University of Rouen Normandy, Mont-Saint-Aignan, France.
EFORT Open Rev. 2024 Oct 3;9(10):933-940. doi: 10.1530/EOR-23-0093.
Recurrence of hallux valgus (HV) following corrective surgery is a frequent concern. A recent systematic review estimated recurrence of HV in only 4.9%, which may be an underestimation, as most included studies had short- to mid-term follow-up. The purpose of this systematic review and meta-analysis was to synthesize and critically appraise the literature on the long-term outcomes of shaft osteotomies of the first metatarsal (M1) to treat HV without inflammatory disease or degenerative arthritis, and to assess the long-term HV recurrence rates of studies with a minimum follow-up of 5 years.
This systematic review conforms to the PRISMA guidelines. The authors conducted a search using PubMed, Embase®, and Cochrane Central Register of Controlled Trials databases. Studies that report outcomes of shaft osteotomies of the M1 for non-inflammatory and non-degenerative HV having a minimum follow-up of 5 years were included. We found five eligible studies comprising six datasets, all assessed Scarf osteotomies with a mean follow-up that ranged from 8 to 14 years.
The HV recurrence rate was 40%, considering the threshold of >15° hallux valgus angle (HVA), 30% having >20°, and 2% having >25°.
At a minimum follow-up of 8 years following shaft osteotomies of M1, the HVA was 15.9°, the intermetatarsal angle (IMA) was 7.7°, and the DMAA was 8.3°. Furthermore, the recurrence rates considering the various thresholds of HVA were: 40% having >15°, 20% having >20°, and 2% having >25°.
Meta-analysis, Level IV.
拇外翻（HV）矫正手术后的复发是一个常见问题。最近的一项系统评价估计HV的复发率仅为4.9%，这可能是低估了，因为大多数纳入研究的随访时间为短期至中期。本系统评价和荟萃分析的目的是综合并批判性评价关于第一跖骨（M1）骨干截骨术治疗无炎症性疾病或退行性关节炎的HV的长期结局的文献，并评估随访至少5年的研究中HV的长期复发率。
本系统评价符合PRISMA指南。作者使用PubMed、Embase®和Cochrane对照试验中央注册库数据库进行检索。纳入报告M1骨干截骨术治疗非炎症性和非退行性HV且随访至少5年的结局的研究。我们发现五项符合条件的研究，包括六个数据集，均评估了Scarf截骨术，平均随访时间为8至14年。
考虑拇外翻角（HVA）>15°的阈值时，HV复发率为40%，HVA>20°时为30%，HVA>25°时为2%。
在M1骨干截骨术后至少随访8年时，HVA为15.9°，跖间角（IMA）为7.7°，远端关节面角（DMAA）为8.3°。此外，考虑不同HVA阈值的复发率为：HVA>15°时为40%，HVA>20°时为20%，HVA>25°时为2%。
荟萃分析，IV级。
