Purpose The purpose of this study was to compare a minimally invasive chevron osteotomy technique (MIS group) and the wellestablished open chevron technique (OC group) for correction of hallux valgus deformity. Methods Patients who were scheduled to undergo a hallux valgus surgery by means of a distal chevron osteotomy were randomly assigned to one of the two groups. Pre-operatively, six weeks, 12 weeks, and nine months post-operatively the following outcome parameters were determined: Visual Analog Scores (VAS) of pain, the American Orthopedic Foot and Ankle Society (AOFAS) forefoot score, radiographic outcome measures, range of motion (ROM), and patient satisfaction. Results Forty-seven cases were analyzed (25 MIS group; 22 OC group). Both operative techniques achieved significant correction of the hallux deformity. The intermetatarsal angle (IMA) improved from 15.1°to 5.8°in the OC and from 14°to 6.8°in the MIS group, whereas the hallux valgus angle (HVA) improved from 28.3°to 8.5°in the OC versus 26.4°to 6.9°in the MIS group. No significant differences were observed between the groups by any of the determined outcome parameters. Regarding patient satisfaction, statistically significant differences were found between MIS and open surgery 12 weeks post-operatively in favour of the MIS group (p = 0.022). Conclusion With the minimally invasive chevron osteotomy, radiological and clinical outcome is comparable to the open technique.

Purpose Prior studies have reported improved gait performance and kinematics after total ankle arthroplasty (TAR) compared to ankle arthrodesis (AAD). Given these findings, AAD has been primarily considered as a salvage procedure that may lead to adjacent joint degeneration. Methods A total of 101 TAR and 40 screw arthrodeses were enrolled in a retrospective study with a prospectively designed follow-up examination that included gait analysis and outcome assessment with the AOFAS hindfoot score and FAOS questionnaire. Results Significant asymmetry in gait and reduced range of motion compared to normal remained after both procedures. Subjective outcome improved after both procedures, and pain was significantly better after TAR. Limited functional gains after TAR and joint degeneration to the same degree after both procedures was seen in the mid-term. Hindfoot fusion seemed to have a greater impact on postoperative function than ankle arthrodesis. Conclusion Considering only minor functional gains of TAR compared to AAD the implantation of current TAR designs in large patient series may be questioned.

Level III, comparative series.

Therapeutic, Level IV, retrospective case series.