{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T11:45:11Z","timestamp":1793015111461,"version":"4.5.0"},"reference-count":28,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2019,9,14]],"date-time":"2019-09-14T00:00:00Z","timestamp":1568419200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Foot Ankle Int."],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Multiple operative techniques have been developed for hallux valgus with varying success. The most recent developments in minimally invasive surgery have evolved into the third-generation minimally invasive chevron Akin (MICA) osteotomy. Good results have been shown from originator centers, but this is one of the first series from a nonoriginator center, and the first to use a validated patient-reported outcome measure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Forty consecutive patients undergoing third-generation MICA for hallux valgus were included. Primary outcome measures included Manchester-Oxford Foot Questionnaire (MOXFQ) and American Orthopaedic Foot &amp; Ankle Society (AOFAS) scores and Coughlin satisfaction rates at 12 months. Secondary outcome measures included radiographic parameters, complications, and recurrence rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>At 12 months, the MOXFQ score improved from 58 to 10 and the AOFAS score improved from 48 to 93, with 70% of patients reporting excellent outcomes and 30% good ones. Two cases started as mild, 29 cases as moderate, and 9 cases as severe as defined by radiographic criteria. Hallux valgus angles improved from 32 degrees to 12 degrees, and intermetatarsal angles improved from 13 degrees to 7 degrees. There were 4 cases of Akin screw removal for soft tissue irritation. There were no other complications, including recurrence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The third-generation MICA technique was a safe and effective approach to treating hallux valgus. Further research should focus on long-term outcomes and comparative data with other commonly performed operative techniques.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>Level IV, case series.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1071100719874360","type":"journal-article","created":{"date-parts":[[2019,9,14]],"date-time":"2019-09-14T08:02:08Z","timestamp":1568448128000},"page":"50-56","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":98,"title":["Third-Generation Minimally Invasive Chevron Akin Osteotomy for Hallux Valgus"],"prefix":"10.1177","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4134-1472","authenticated-orcid":false,"given":"Thomas J.","family":"Holme","sequence":"first","affiliation":[{"name":"Department of Trauma & Orthopaedics, Croydon University Hospital, Croydon, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sivan S.","family":"Sivaloganathan","sequence":"additional","affiliation":[{"name":"Department of Trauma & Orthopaedics, Croydon University Hospital, Croydon, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beejal","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Trauma & Orthopaedics, Croydon University Hospital, Croydon, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kumar","family":"Kunasingam","sequence":"additional","affiliation":[{"name":"Department of Trauma & Orthopaedics, Croydon University Hospital, Croydon, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,9,14]]},"reference":[{"key":"bibr1-1071100719874360","doi-asserted-by":"publisher","DOI":"10.1177\/2473011417S000101"},{"key":"bibr2-1071100719874360","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2017.06.027"},{"key":"bibr3-1071100719874360","doi-asserted-by":"publisher","DOI":"10.1177\/107110070202300808"},{"key":"bibr4-1071100719874360","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3181b13ca2"},{"key":"bibr5-1071100719874360","doi-asserted-by":"publisher","DOI":"10.1177\/107110079101100402"},{"key":"bibr6-1071100719874360","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2007.0759"},{"key":"bibr7-1071100719874360","doi-asserted-by":"publisher","DOI":"10.1177\/107110070202300114"},{"key":"bibr8-1071100719874360","doi-asserted-by":"publisher","DOI":"10.1177\/1758573217744178"},{"key":"bibr9-1071100719874360","unstructured":"Department for Communities and Local Government. Annual Report and Accounts 2015-16. https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/536593\/56046_DCLG_ARA_Web_only.pdf. Accessed August 23, 2019."},{"issue":"12","key":"bibr10-1071100719874360","first-page":"2330","volume":"32","author":"Harrison MJ","year":"2005","journal-title":"J Rheumatol"},{"key":"bibr11-1071100719874360","unstructured":"Health Service Executive (Ireland). Section 7: Diagnostic Reference Levels (DRLs): Establishment and Use of Diagnostic Reference Levels (DRLs). https:\/\/www.hse.ie\/eng\/about\/who\/qualityandpatientsafety\/safepatientcare\/medexpradiatonunit\/section%207%20diagnostic%20reference%20levels%20rp%20manual.pdf. Accessed June 26, 2019."},{"key":"bibr12-1071100719874360","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2017.01.002"},{"key":"bibr13-1071100719874360","doi-asserted-by":"publisher","DOI":"10.1177\/107110079401500701"},{"key":"bibr14-1071100719874360","doi-asserted-by":"publisher","DOI":"10.11124\/JBISRIR-2017-003422"},{"key":"bibr15-1071100719874360","doi-asserted-by":"publisher","DOI":"10.1016\/j.jotr.2014.02.001"},{"key":"bibr16-1071100719874360","doi-asserted-by":"publisher","DOI":"10.1016\/j.fcl.2014.06.003"},{"key":"bibr17-1071100719874360","doi-asserted-by":"publisher","DOI":"10.1177\/1071100717704941"},{"key":"bibr18-1071100719874360","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.98B3.35666"},{"key":"bibr19-1071100719874360","doi-asserted-by":"publisher","DOI":"10.1093\/bmb\/ldq027"},{"key":"bibr20-1071100719874360","doi-asserted-by":"publisher","DOI":"10.1016\/j.fas.2017.12.010"},{"key":"bibr21-1071100719874360","doi-asserted-by":"publisher","DOI":"10.1302\/2046-3758.24.2000147"},{"key":"bibr22-1071100719874360","unstructured":"National Institute for Health and Care Excellence. Overview | Surgical correction of hallux valgus using minimal access techniques | Guidance | NICE. https:\/\/www.nice.org.uk\/Guidance\/IPG332. Accessed June 12, 2019."},{"key":"bibr23-1071100719874360","unstructured":"National Institute for Health and Care Excellence. Surgical correction of hallux valgus using minimal access techniques | Guidance and guidelines | NICE. https:\/\/www.nice.org.uk\/guidance\/ipg332\/chapter\/1-Guidance. Accessed October 18, 2018."},{"issue":"1","key":"bibr24-1071100719874360","first-page":"50","volume":"3","author":"Perera A","year":"2015","journal-title":"J Trauma Orthop"},{"key":"bibr25-1071100719874360","doi-asserted-by":"publisher","DOI":"10.1186\/1757-1146-2-15"},{"key":"bibr26-1071100719874360","unstructured":"Public Health England. National Diagnostic Reference Levels (NDRLs). https:\/\/www.gov.uk\/government\/publications\/diagnostic-radiology-national-diagnostic-reference-levels-ndrls\/national-diagnostic-reference-levels-ndrls. 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