{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T03:18:35Z","timestamp":1792639115911,"version":"4.5.0"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"13","license":[{"start":{"date-parts":[[2021,3,25]],"date-time":"2021-03-25T00:00:00Z","timestamp":1616630400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,7,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>There is interest in hallux valgus deformity correction using internal fixation with the minimally invasive chevron and Akin osteotomies (MICA) technique. The objective of this study was to assess the correction measured on postoperative radiographs and clinical outcomes, using validated outcome measures, at 2 years following third-generation MICA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This is a prospective single-surgeon case series of 333 consecutive feet that underwent MICA surgery between July 2014 and April 2018. The primary clinical outcome measures included the Manchester-Oxford Foot Questionnaire (MOXFQ), EuroQol-5 Dimensions-5 Level (EQ-5D-5L) Index, EuroQol-visual analogue scale (EQ-VAS), and a VAS for pain (VAS-pain). Secondary outcome measures included radiographic parameters and complication rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Preoperative and 2-year postoperative patient-reported outcome measures (PROMs) were collected for 292 feet (87.7%). At a minimum 2-year follow-up, the MOXFQ scores (mean \u00b1 standard deviation [SD]) had improved in each domain\u2014i.e., reduced from 44.5 \u00b1 21.0 preoperatively to 9.4 \u00b1 15.8 postoperatively for pain (p &lt; 0.001), from 38.7 \u00b1 23.4 to 6.5 \u00b1 14.6 for walking and standing (p &lt; 0.001), and from 48.0 \u00b1 22.3 to 6.6 \u00b1 13.5 for social interaction (p &lt; 0.001). The VAS-pain score improved from 31.4 \u00b1 22.7 preoperatively to 8.4 \u00b1 16.4 at the 2-year follow-up (p &lt; 0.001), the 1-2 intermetatarsal angle was reduced from 15.3\u00b0 \u00b1 3.6\u00b0 preoperatively to 5.7\u00b0 \u00b1 3.2\u00b0 at the 2-year follow-up (p &lt; 0.001), and the hallux valgus angle was reduced from 32.9\u00b0 \u00b1 10.2\u00b0 to 8.7\u00b0 \u00b1 5.2\u00b0 (p &lt; 0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The third-generation MICA provided significant improvement in clinical outcome measures at the 2-year follow-up and can be successfully used for correction of a range of hallux valgus deformities with a low rate of symptomatic recurrence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Therapeutic\n                      <jats:underline>Level IV<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.20.01178","type":"journal-article","created":{"date-parts":[[2021,3,25]],"date-time":"2021-03-25T17:16:35Z","timestamp":1616692595000},"page":"1203-1211","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":116,"title":["Third-Generation Minimally Invasive Chevron and Akin Osteotomies (MICA) in Hallux Valgus Surgery"],"prefix":"10.2106","volume":"103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4167-7427","authenticated-orcid":false,"given":"Thomas L.","family":"Lewis","sequence":"first","affiliation":[{"name":"King\u2019s Foot and Ankle Unit, King\u2019s College Hospital NHS Foundation Trust, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7411-9720","authenticated-orcid":false,"given":"Robbie","family":"Ray","sequence":"additional","affiliation":[{"name":"King\u2019s Foot and Ankle Unit, King\u2019s College Hospital NHS Foundation Trust, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3687-9876","authenticated-orcid":false,"given":"George","family":"Miller","sequence":"additional","affiliation":[{"name":"Guy\u2019s and St Thomas\u2019 NHS Foundation Trust, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2188-7766","authenticated-orcid":false,"given":"David J.","family":"Gordon","sequence":"additional","affiliation":[{"name":"The London Clinic, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,3,25]]},"reference":[{"issue":"1","key":"bib1-20250430","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1053\/j.jfas.2017.06.027","article-title":"Percutaneous osteotomies in hallux valgus: a systematic review","volume":"57","author":"Bia","year":"2018","journal-title":"J Foot Ankle Surg."},{"issue":"3","key":"bib2-20250430","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1007\/s00264-018-4138-x","article-title":"Minimally invasive surgery for hallux valgus: a systematic review of current surgical techniques","volume":"43","author":"Malagelada","year":"2019","journal-title":"Int Orthop."},{"key":"bib3-20250430","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1093\/bmb\/ldq027","article-title":"Hallux valgus: effectiveness and safety of minimally invasive surgery. 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