PONE-D-20-20197

Percutaneous Chevron/Akin versus open scarf/Akin osteotomy treatment for hallux valgus: a systematic review and meta-analysis

PLOS ONE

Dear Dr. Stefani,

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Osama Farouk

Academic Editor

PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Partly

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: No

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Thank you for asking me to review this paper dealing with a comparison between percutaneous Chevron/Akin and traditional Scarf/Akin. The topic is definitely interesting. I think the paper will be suitable for publication after a revision by authors. The most important point will be to remodulate the conclusion, since I don’t believe that data allow to say the early postoperative pain is better for PECA. It can be said that the outcomes are comparable after 6 months, but that no analysis is possible about the early recovery based on published data.

My comments in detail are:

ABSTRACT

I would recommend to include more data in the methods section. In results, how many patients were considered in the 3 studies in total?

INTRODUCTION

Line 59 Better to say The reviews published so far…

METHODS

Line 85 I think here you may want to say ‘…treatment by the SA and PECA technique »

RESULTS

VAS at 1 day is reported only by two studies and at 1 week and 2 weeks by one study

Line 170 Is this Portuguese?

Line 171 Typo

Line 179-180 This is not clear

Line 188 -0.53 what? and in favour of what technique?

Line 193 As above. Please, be clearer when reporting differences

Line 198 As above

Line 206 As above

Line 212 As above

DISCUSSION

Line 233 0.80 what? Please revise the whole paper indicating the Units for values

Line 237-243 I think this paragraph should be remodulated. Was the difference in AOFAS statistically significant? I think you cannot draw any conclusion on the immediate postoperative pain since only one or two studies assessed it.

Line 247 Pain score at VAS cannot be judged only on one or two studies

CONCLUSION

I think that, based on your numbers, you cannot infer that PECA led to less postoperative pain. You may say that the clinical outcome is comparable at 6 and 12 months, and that early recovery cannot be assessed based on current literature.

Reviewer #2: This study addresses a common problem in foot surgery. A well-tried technique is compared with a new percutaneous technique in the context of a meta-analysis. This analysis was carried out technically flawlessly. The only problem I see is that only 3 studies could be included. However, this fact was openly presented and discussed by the authors in the discussion.

Please delete „were excluded“ in line 87

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Reviewer #1: No

Reviewer #2: Yes: PD Dr. med. habil. Kajetan Klos

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Percutaneous Chevron/Akin (PECA) versus open scarf/Akin (SA) osteotomy treatment for hallux valgus: a systematic review and meta-analysis

PONE-D-20-20197R1

Dear Dr. Stefani,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Osama Farouk

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

Reviewer #2: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: I Don't Know

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4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: The authors have addresses all the concerns. I believe that the paper can be published in its current form.

Reviewer #2: (No Response)

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

Reviewer #2: No