All-suture anchor-enhanced capsulorrhaphy versus simple longitudinal capsulorrhaphy combined with Chevron-Akin osteotomy in the treatment of moderate-to-severe hallux valgus: a retrospective cohort study.

BACKGROUND: Hallux valgus (HV) is a common forefoot deformity. The ideal surgical technique for treating moderate-to-severe hallux valgus (HV) is unclear. Surgical methods that effectively restore the balance of soft tissues around the first metatarsophalangeal (MTP1) joint are necessary. This study compared osteotomy combined with either all-suture anchor-enhanced capsulorrhaphy (AEC) or simple longitudinal capsulorrhaphy (SLC). METHODS: Due to the different surgical methods from October 2018 to November 2024, ninety-five patients with moderate-to-severe HV were assigned into the AEC group or the SLC group. Demographic data, clinical scores (Manchester-Oxford Foot Questionnaire, American Orthopaedic Foot & Ankle Society Hallux MTP-IP Scoring Scale, Visual Analogue Scale), and radiological parameters(Hallux valgus angle (HVA), intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA)) collected before surgery, at 3 months after surgery and at the last follow-up (minimum 6 months, mean 12.41 ± 6.04 months) were retrospectively analyzed, and complications and recurrence were monitored. RESULTS: All patients showed significant improvement in clinical scores and radiological parameters after surgery (p < 0.001). IMA, MOXFQ, AOFAS, and VAS scores were not significantly different between the two groups. At 3 months after the operation, the AEC group showed significantly lower HVA (AEC: 4.7°±3.2°, SLC: 8.5°±2.6°, p < 0.001) and DMAA (AEC: 3.4°±2.8°, SLC: 5.5°±2.1°, p < 0.001) compared to the SLC group. At the last follow-up, the AEC group also showed significantly lower HVA (6.8°±3.8° vs. 11.9°±3.6°, p < 0.001) and DMAA (4.8°±3.3° vs. 7.3°±2.2°, p < 0.001). The AEC group showed a numerically higher rate of normal joint congruency (44/49, 89.8% vs. 34/46, 73.9%, p = 0.044). CONCLUSION: Both AEC and SLC combined with Chevron-Akin osteotomy were safe and effective techniques for correcting moderate-to-severe HV, although AEC exhibited a greater corrective of HVA and DMAA. Additionally, the joint congruency rate in the AEC group at the last follow-up was nominally higher. LEVELS OF EVIDENCE: Level IV.