Proximal Articular Set Angle Correction with the Reverdin-Isham Osteotomy in Mild and Moderate Hallux Valgus: A Systematic Review and Meta-Analysis.
Systematic Review
The Reverdin-Isham osteotomy via minimal incision is a prominent option for the surgical treatment of hallux valgus, a foot deformity characterized by medial deviation of the first metatarsal and lateral deviation of the first toe. This technique is particularly indicated for cases with an elevated proximal articular angle, enabling effective correction and improved foot functionality. However, its efficacy has not been fully established in the scientific literature. Objective: The main objective of this analysis was to evaluate the correction of radiological angles (PASA, IMA, and HVA), the improvement in functionality according to the AOFAS scale, pain reduction, and patient satisfaction. A systematic review was conducted following the PRISMA guidelines in scientific databases such as PubMed, Scopus, and Web of Science, assessing publication biases and heterogeneity. Ten studies were included, covering 579 procedures in 500 patients, with an average follow-up of 33.8 months. The results did not show significant improvements in the PASA ( = 0.14; CI [-1.52, 0.32]), not in the AIM ( = 0.05; CI [-2.63, 0.02]), although the meta-regression was statistically significant ( = 0.0022) with a ratio of 61.2%. It did show significant improvements in the AHV ( = 0.0009; CI [-3.14, -1.33]). An increase of 37.4 points in the AOFAS scale was revealed, and a 5.4-point reduction in pain. Patient satisfaction was high, with 89.3% of patients satisfied and 94.7% willing to undergo the procedure again. However, 20 major complications were reported, primarily recurrences. The Reverdin-Isham osteotomy is a safe and effective technique for treating mild-to-moderate hallux valgus. It offers significant improvements in foot functionality and pain reduction, with high patient satisfaction rates. Although recurrences remain the main complication, their low frequency reinforces the validity of the technique as a surgical option for specific deformities.
