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MInimally Invasive Hallux Valgus Surgery

27 April 2010

 British Orthopaedic Foot and Ankle Surgery

Steering Group on Minimally Invasive Surgery


Steering Group Membership:            Stephen Bendall

David Redfern

Anthony Sakellariou

Andrew “Fred” Robinson (Chair)


The purpose of the group


Minimally Invasive Surgery of the foot and ankle (MIS) encompasses a variety of procedures for use in Hallux Valgus, Hallux Rigidus and lesser toe disorders. MIS is currently widely practiced outside the United Kingdom (UK); however, uptake in the UK has been guarded. The British Orthopaedic Foot and Ankle Society (BOFAS) has established this group to advise its members on MIS. The group’s findings, after appropriate assessment, will be reported to BOFAS Council via the education committee.


What is the current position?


Current Practice:

There are currently a small number of orthopaedic surgeons practicing MIS in the UK. This number is slowly increasing.



Engagement with the National Institute for Clinical Excellence (NICE).


Some panel members have acted as advisors to NICE. A position statement with regard to MIS from NICE is awaited.



It is the group’s view that those engaging in MIS forefoot surgery should:


·      Have sufficient training in MIS techniques.

·      Use appropriate equipment.

·      Treat patients as part of a locally organised audit or clinical trial.

·      Inform their patients that MIS is a new technique and that, at the current time, the long-term results are not available.

·      Be prepared to submit their results to the peer review process


Recommendations to BOFAS Council


  • MIS forefoot surgery is not currently a technique that can be supported for widespread general use within the UK.
  • Clinicians who are interested in developing this method should adhere to the guidelines above.
  • A view will be taken by BOFAS on this technique in time, based on evidence that is peer reviewed.


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