{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:47:01Z","timestamp":1787755621633,"version":"build-2784847793"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T00:00:00Z","timestamp":1719792000000},"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":[],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>This study aimed to evaluate the long-term results of hallux valgus correction with a distal metatarsal reversed-L (ReveL) osteotomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Eighty-eight patients (131 feet) were evaluated after a mean follow-up of 14.2 years (range, 10 to 18 years). Weight-bearing foot radiographs were analyzed preoperatively, at 6 weeks postoperatively, and at the final follow-up for the following parameters: hallux valgus angle (HVA), intermetatarsal angle (IMA), first metatarsophalangeal joint (MTPJ) congruence angle, sesamoid position, presence of the round sign, and first MTPJ arthritis. The visual analog scale (VAS) and the Foot and Ankle Outcome Score (FAOS) assessed postoperative pain and function. Univariate and multivariable logistic regression analyses identified risk factors for hallux valgus recurrence and an inferior clinical outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      All radiographic parameters significantly improved at the 6-week follow-up and the final follow-up (p &lt; 0.001). The recurrence rate (HVA &gt;20\u00b0) was 14%. A preoperative HVA of &gt;28\u00b0 (odds ratio [OR], 9.1; p = 0.02) and a 6-week postoperative HVA of &gt;15\u00b0 (OR, 4.6; p = 0.03) were independent risk factors for recurrence. At the final follow-up, all FAOS subscales resembled high postoperative function (median, 100 points [range of the interquartile range (IQR), 81 to 100 points]). A preoperative body mass index of &gt;30 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      was associated with lower FAOS quality of life (QOL) (p = 0.04), and postoperative hallux varus was associated with lower FAOS activities of daily living (p = 0.048). Patients with first MTPJ arthritis of grade 2 or higher at the final follow-up had significantly lower FAOS subscales (p &lt; 0.01) except for QOL. Hallux valgus recurrence did not influence the long-term outcome. A symptomatic implant was the main cause of revision (15%). In 94% of cases, the patients were satisfied with the hallux appearance and, in 92% of cases, the patients were satisfied with postoperative pain reduction.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Hallux valgus correction with a ReveL osteotomy led to high long-term satisfaction rates. A preoperative HVA of &gt;28\u00b0 and a 6-week postoperative HVA of &gt;15\u00b0 increased the risk of hallux valgus recurrence. First MTPJ arthritis was the leading cause of inferior clinical results, whereas radiographic hallux valgus recurrence had no impact on the clinical results. First MTPJ arthritis at the final follow-up was associated with an inferior clinical outcome, whereas radiographic hallux valgus recurrence had no impact on the long-term clinical results.<\/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.oa.24.00042","type":"journal-article","created":{"date-parts":[[2024,9,13]],"date-time":"2024-09-13T14:30:07Z","timestamp":1726237807000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Long-Term Results After Hallux Valgus Correction with Distal Metatarsal Reversed-L (ReveL) Osteotomy"],"prefix":"10.2106","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2747-2310","authenticated-orcid":false,"given":"Lizzy","family":"Weigelt","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, University Hospital Balgrist, University of Zurich, Zurich, Switzerland"},{"name":"Department of Orthopaedics and Trauma Surgery, Lucerne Cantonal Hospital, Lucerne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4699-0623","authenticated-orcid":false,"given":"Noah","family":"Davolio","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Zurich, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3267-8897","authenticated-orcid":false,"given":"Carlos","family":"Torrez","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University Hospital Balgrist, University of Zurich, Zurich, Switzerland"},{"name":"Department of Orthopaedics and Trauma Surgery, Lucerne Cantonal Hospital, Lucerne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Haug","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University Hospital Balgrist, University of Zurich, Zurich, Switzerland"},{"name":"Department of Orthopaedics and Trauma Surgery, Lucerne Cantonal Hospital, Lucerne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5499-2751","authenticated-orcid":false,"given":"Nathalie","family":"K\u00fchne","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University Hospital Balgrist, University of Zurich, Zurich, Switzerland"},{"name":"Unit of Clinical and Applied Research, Balgrist University Hospital, University of Zurich, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6356-5338","authenticated-orcid":false,"given":"Stephan H.","family":"Wirth","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University Hospital Balgrist, University of Zurich, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,7]]},"reference":[{"issue":"10","key":"R1-20250310","doi-asserted-by":"crossref","first-page":"873","DOI":"10.2106\/JBJS.19.00981","article-title":"Five-year follow-up of minimally invasive distal metatarsal chevron osteotomy in comparison with the open technique: a randomized controlled trial","volume":"102","author":"Kaufmann","year":"2020","journal-title":"J Bone Joint Surg Am"},{"issue":"6","key":"R2-20250310","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1016\/j.fas.2018.09.003","article-title":"Chevron osteotomy versus Scarf osteotomy for hallux valgus correction: a meta-analysis","volume":"25","author":"Ma","year":"2019","journal-title":"Foot Ankle Surg"},{"issue":"4","key":"R3-20250310","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1016\/j.fas.2020.04.013","article-title":"Overview of randomised controlled trials in hallux valgus surgery (2,184 patients)","volume":"27","author":"Matar","year":"2021","journal-title":"Foot Ankle Surg"},{"issue":"15","key":"R4-20250310","doi-asserted-by":"crossref","first-page":"1238","DOI":"10.2106\/JBJS.N.00971","article-title":"The Scarf osteotomy with minimally invasive lateral release for treatment of hallux valgus deformity: intermediate and long-term results","volume":"97","author":"Bock","year":"2015","journal-title":"J Bone Joint Surg Am"},{"issue":"7","key":"R5-20250310","doi-asserted-by":"crossref","first-page":"1016","DOI":"10.1302\/0301-620X.86B7.15108","article-title":"Chevron osteotomy in hallux valgus. 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