# Proximal Articular Set Angle Correction with the Reverdin–Isham Osteotomy in Mild and Moderate Hallux Valgus: A Systematic Review and Meta-Analysis

## TL;DR

This study reviews the effectiveness of a surgical technique for correcting mild to moderate hallux valgus foot deformity, finding it improves functionality and reduces pain with high patient satisfaction.

## Contribution

A systematic review and meta-analysis evaluating the clinical outcomes of the Reverdin–Isham osteotomy for hallux valgus.

## Key findings

- The procedure significantly improved the hallux valgus angle and AOFAS scores.
- Patient satisfaction was high, with 89.3% satisfied and 94.7% willing to repeat the surgery.
- Major complications, mainly recurrences, occurred in 20 cases but were relatively rare.

## Abstract

Background and Objectives: 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. Materials and Methods: 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. Results: The results did not show significant improvements in the PASA (p = 0.14; CI [−1.52, 0.32]), not in the AIM (p = 0.05; CI [−2.63, 0.02]), although the meta-regression was statistically significant (p = 0.0022) with a ratio of 61.2%. It did show significant improvements in the AHV (p = 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. Conclusions: 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.