Outcomes Following Minimally Invasive vs Open Cheilectomy for Hallux Rigidus: A Systematic Review
Bibliographic record
Abstract
IntroductionHallux rigidus is common and can be disabling for patients. Once conservative management is exhausted, surgical treatment is considered. For earlier stage hallux rigidus, cheilectomy can be offered to patients. Traditionally, open cheilectomy has been performed, but minimally invasive cheilectomy is becoming increasingly popular. The purpose of this systematic review is to compare the outcomes of minimally invasive vs open cheilectomy for hallux rigidus.MethodsTwo comprehensive literature searches of Ovid MEDLINE and EMBASE were performed for relevant publications from January 1, 1995 to April 9, 2024. Search terms focused on open and minimally invasive surgery (MIS) cheilectomy were used. All full-text, English-language, clinical studies reporting on MIS and open cheilectomy outcomes and/or complications were included. Article screening, critical appraisal, and data extraction were performed independently by 2 reviewers.ResultsNine MIS cheilectomy studies were identified, reporting on a total of 442 patients (95 males, 214 females, and 133 not reported) with 464 feet operated on. The weighted mean age and follow-up were 50.7 ± 4.6 years and 33. 5 ±14.0 months, respectively. Fifteen open cheilectomy studies were identified, yielding 720 patients (199 males, 319 females, and 202 not specified) and 763 operated feet. The weighted mean age and follow-up was 53.2 ± 4.7 years and 64.5 ± 28.3 months, respectively. Functional outcomes are similar following open or MIS cheilectomy. The MIS cheilectomy studies reported a total of 37 complications (8.2%) and 43 revision surgeries (9.3%). Complications and revision surgery following open cheilectomy were 14.7% (n = 112) and 5.0% (n = 38), respectively. Complications following open cheilectomy were higher than with MIS cheilectomy (P = .001). However, revision surgery was found to be higher in patients following MIS cheilectomy (P = .003).ConclusionSurgical complications following MIS cheilectomy were found to be less common when compared to open cheilectomy. However, there may be an increased risk of revision surgery following MIS cheilectomy.Level of Evidence:III (systematic review of level III-IV studies).
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.007 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.014 | 0.005 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; both teacher heads agree on what is shown here.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".