SynthesisBMC musculoskeletal disorders2024
Evaluating the learning curve of Minimally Invasive Chevron and Akin Osteotomy for correction of hallux valgus deformity: a systematic review.
Synthesis in BMC musculoskeletal disorders, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Percutaneous First Metatarsophalangeal Joint Arthrodesis With Single‑Screw Fixation: Technique and 24‑Month Clinical and Radiographic Outcomes.Foot & ankle orthopaedics · 2026Article
- A retrospective radiographic comparative study of 113 feet undergoing joystick-assisted minimally invasive surgery (MIS) vs. minimally invasive Chevron-Akin (MICA) for hallux valgus correction.Archives of orthopaedic and trauma surgery · 2025Article
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Authors and funding
6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundOne procedure that has gained popularity in the surgical management of hallux valgus is the minimally invasive Chevron and Akin osteotomy (MICA). The purpose of this systematic review was to evaluate the learning curve associated with this technically demanding procedure.
methodsA search of the EMBASE and PubMed databases was performed to identify all clinical studies that assessed the learning curve associated with the MICA procedure. Studies where patients were not diagnosed with hallux valgus, did not undergo MICA, or did not report data on operation time, fluoroscopy exposure, or complications were excluded. A risk of bias assessment was conducted to assess the validity of the studies.
resultsThe initial literature search yielded 287 studies, and seven studies were included in the final analysis. A quantitative comparative analysis could not be performed as the included studies used different statistical methods to quantify the learning curve. Lewis et al. determined that after 38 operations, there was a decrease in operation time and fluoroscopy exposure (p < .001). Merc et al. found that it took 29 and 30 operations to reach a plateau for operation time and fluoroscopy exposure, respectively (p < .001). Palmanovich et al. found that it took 20 and 26 operations to reach a plateau for operation time and fluoroscopy exposure, respectively (p < .001). Toepfer and Strässle found there was a significant decrease in operation time and fluoroscopy exposure after the first 19 procedures in their series (p < .001). With respect to complications, one study found a significant difference after the 42nd operation (p = .007). However, the remaining studies found that complication rates did not significantly change with increased technical proficiency. All seven studies were deemed to have a moderate risk of bias.
conclusionsSurgeons can expect a learning curve of 20 to 40 operations before reaching technical proficiency with the MICA procedure. After the learning curve is achieved, surgeons can expect to see a significant decrease in both operation times and fluoroscopy exposure. No consistent significant difference was found in complications as one becomes more technically proficient with the procedure.
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