Page 36 - HOI Outcomes 2019
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Historically the idea of the minimally invasive bunion correction is not new. However, until recently, outcomes were traditionally poor. The first minimally invasive bunion surgery technique was described in the early 1980s as the Reverdin-Isham procedure. It included a percutaneous medial closing wedge osteotomy of the first metatarsal without any internal fixation. With this technique there were poor outcomes including a high recurrence rate, hallux shortening, as well as risks of a vascular necrosis. This technique was subsequently modified by Bösch and Giannini which involved a percutaneous transverse osteotomy followed by temporary fixation with an axial Steinman pin; however, this also resulted in similarly poor outcomes and high recurrence rates. Compared to these previous techniques, the current MICA procedure has excellent outcomes equal to traditional open procedures with lower post-operative complications (especially wound complications) and earlier return to activity which is well documented in peer reviewed foot and ankle journals. Most notably, this technique can be used for patients of all ages and activities – as well as mild, moderate, and severe bunions – with excellent outcomes, alignment, function, and patient satisfaction.
Hoag Orthopedic Institute was the first facility in the state of California and the entire West Coast to perform the FDA approved minimally invasive bunion surgery. The orthopedic foot and ankle surgeons at Hoag Orthopedic Institute are not only well trained
and experienced in minimally invasive techniques in foot and ankle surgery but also serve as regional and national instructors and educators on these techniques. Furthermore, the percutaneous minimally invasive techniques can be applied to numerous foot and ankle conditions including bunions, bunionettes, hammertoes, calcaneal osteotomies (flatfeet, cavovarus feet), Charcot deformity correction, and Achilles tendinopathies.
At Hoag Orthopedic Institute we strive to not only provide our patients with the highest level of care to ensure excellent outcomes, but also to be on the forefront of advancements in orthopedic surgery. This includes innovation in surgical techniques, education, and collaboration to provide our patients with the mutual goal of “Getting you back to you.”
For Alyssa’s story, see page 50, or visit

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