Abstract
Autogenous soft tissue interpositional arthroplasty has been proposed as an alternative
to arthrodesis and other forms of arthroplasty for treatment of end-stage hallux rigidus
because of the perceived safety and efficacy. The author undertook a systematic review
of electronic databases and other relevant sources to identify material relating to
the outcomes following autogenous soft tissue interpositional arthroplasty for end-stage
hallux rigidus. Information from peer-reviewed journals, as well as from non–peer-reviewed
publications, abstracts and posters, textbooks, and unpublished works, were also considered.
In an effort to procure the highest quality studies available, studies were eligible
for inclusion only if they involved consecutively enrolled patients undergoing isolated
autogenous soft tissue interpositional arthroplasty for the treatment of end-stage
hallux rigidus, evaluated patients at mean follow-up of 12-months' duration or longer,
included pre- and postoperative range of motion of the first metatarsal-phalangeal
joint, determined pre- and postoperative outcomes using a scoring system, and documented
any complications. Two studies involving a total of 28 autogenous soft tissue interpositional
arthroplasties for end-stage hallux rigidus were identified that met the inclusion
criteria. There were 12 men (52%) and 11 women (48%) with a mean age of 58.2 years
followed for a mean of 21.6 months. Both studies used the AOFAS First Metatarsal-Phalangeal-Hallux
Scoring System, which had a mean of 26.0 preoperatively rising to 89.4 postoperatively.
First metatarsal-phalangeal joint dorsiflexion had a mean of 16.7° preoperatively
rising to 51.1° postoperatively. Complications occurred in 4 (14.3%) feet and no feet
required surgical revision. The results of this systematic review demonstrate improvement
in patient outcomes and first metatarsal-phalangeal joint dorsiflexion, as well as
few complications following autogenous soft tissue interpositional arthroplasty for
end-stage hallux rigidus. However, there is still a need for methodologically sound
prospective cohort studies that compare autogenous soft tissue interpositional arthroplasty
with other forms of arthroplasty and arthrodesis for end-stage hallux rigidus.
Level of Evidence
Keywords
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References
- Current concepts review: hallux rigidus and osteoarthrosis of the first metatarsophalangeal joint.J Bone Joint Surg. 1998; 80-A: 898-908
- Hallux rigidus: demographics, etiology, and radiographic assessment.Foot Ankle Int. 2003; 24: 731-743
- Current concepts review: hallux rigidus.Foot Ankle Int. 2008; 29: 637-646
- A comprehensive review of hallux limitus.J Foot Surg. 1984; 23: 213-220
- Hallux limitus and hallux rigidus: clinical examination, radiographic findings, and natural history.Clin Podiatr Med Surg. 1996; 13: 423-448
- A prospective comparison of clinical, radiographic, and intra-operative features of hallux limitus and hallux rigidus.J Foot Ankle Surg. 2002; 4: 76-95
- A prospective comparison of clinical, radiographic, and intra-operative features of hallux limitus and hallux rigidus: short-term follow-up and analysis.J Foot Ankle Surg. 2002; 41: 158-165
- Metatarsus primus elevatus in hallux rigidus: fact or fiction?.J Am Podiatr Med Assoc. 2005; 95: 221-228
Beresford S. Hallux limitus/hallux rigidus: an evaluation and critical review of the aetiology of hallux limitus/hallux rigidus [dissertation no. 20086344]. Northampton, UK: Division of Podiatry, Centre for Healthcare Education, Faculty of Applied Science, University of Northampton School of Medicine. Published online 2005. Available at: http://www2.northampton.ac.uk/pls/portal/docs/1/1175803.PDF. Accessed November 29, 2009.
- Surgical options for salvage of end-stage hallux rigidus.Foot Ankle Clin. 2002; 7: 49-73
Uddin A. A review of the literature: the importance of the first metatarsal-phalangeal joint and the surgical procedures for hallux limitus/rigidus [dissertation no. 20153280]. Northampton, UK: Division of Podiatry, Centre for Healthcare Education, Faculty of Applied Science, University of Northampton School of Medicine. Published online April 2006. Available at: http://www2.northampton.ac.uk/pls/portal/docs/1/3169830.PDF. Accessed November 29, 2009.
- Hallux rigidus: etiology, clinical presentation and methods of treatment-literature review.Arthroscopy J Surg. 2008; 4: 17-30
- Impingement syndromes.in: Baxter D. Hurley R. The Foot and Ankle in Sport. Mosby-Year Book, St. Louis1995: 23
- Capsular interposition arthroplasty for severe hallux rigidus.Foot Ankle Int. 1997; 18: 68-70
- Hallux rigidus: excisional arthroplasty.Foot Ankle Clin. 2000; 5: 663-671
- The modified Keller procedure: dorsal approach interposition arthroplasty sparing the flexor tendons. American Orthopaedic Foot and Ankle Society, 17th Annual Summer Meeting, Final Program.Foot Ankle Int. 2001; 17: 99
- Outcomes following cheilectomy and interpositional arthroplasty in hallux rigidus.Foot Ankle Int. 2001; 22: 462-470
- The modified oblique Keller procedure: a technique for dorsal approach interposition arthroplasty sparing the flexor tendons.Foot Ankle Int. 2003; 24: 521-522
- Interposition resection arthroplasty for hallux rigidus.Tech Foot Ankle Surg. 2004; 3: 158-164
- Degenerative joint disease of the midfoot and forefoot: forefoot arthritis: hallux rigidus.in: Thordarson D.B. Orthopaedic Surgery Essentials: Foot and Ankle. Lippincott Williams & Wilkins, Philadelphia2004: 227-230
- Problems of the great toe: hallux rigidus.in: Nunley J.A. Pfeffer G.B. Sanders R.W. Trepman E. Advanced Reconstruction Foot and Ankle. American Academy of Orthopaedic Surgeons, Rosemont, IL2004: 53-57
- Surgical treatment of the hallux rigidus.Foot Ankle Clin. 2005; 10: 75-96
- Capsular interposition arthroplasty offers an option over fusion for hallux rigidus.Orthopedics Today. 2006; 26 (Available at:) (Accessed November 29, 2009): 62-63
- Outcomes after interpositional arthroplasty for treatment of hallux rigidus.Clin Orthop Relat Res. 2006; 445: 210-215
- Analysis of modified oblique Keller procedure for severe hallux rigidus.Foot Ankle Int. 2008; 29: 1203-1208
- Resection arthroplasty with and without capsular interposition for treatment of severe hallux rigidus.Int Orthop. 2009; 33: 145-150
- Great toe (metatarsophalangeal joint) arthritis: surgical treatment: interpositional grafting.in: Coetzee J.C. Hurwitz S.R. Arthritis and Arthroplasty: The Foot and Ankle. Elsevier Saunders, Philadelphia2010: 314-318
- Distally-based capsule-periosteum interpositional arthroplasty for hallux rigidus: indications, operative technique, and short-term follow-up.J Am Podiatr Med Assoc. 2003; 93: 349-366
- Hallux rigidus.in: Myerson M.S. Reconstructive Foot and Ankle Surgery. Elsevier Saunders, Philadelphia2005: 74-77
- The modified Valenti procedure for the treatment of hallux limitus.J Foot Ankle Surg. 1994; 33: 365-367
- The Valenti procedure for hallux limitus/rigidus.J Foot Ankle Surg. 1995; 34: 485-488
- The Valenti procedure for hallux limitus: a long-term follow-up and analysis.J Foot Ankle Surg. 1999; 38: 123-130
- Die resektionsarthroplastik nach Valenti zur behandlung des fortgeschrittenen hallux rigidus.Operative Orthopädie und Tramatologie. 2008; 20: 492-499
- The Valenti procedure in the treatment of hallux rigidus.Orthopaedics and Traumatology: Surgery and Research. 2009; 95: 202-209
- The surgical treatment of bunions and hallux valgus.NY Med J. 1904; 80: 741
- Zur operativen Therapie des Halluz valgus.Zbl Chir. 1929; 56: 2434
- Keller bunionectomy with fascia and tendon graft.J Am Podiatr Med Assoc. 1986; 76: 602-609
- Medial capsular interpositional arthroplasty for severe hallux rigidus.Foot Ankle Int. 2009; 30: 494-499
- Perichondrial arthroplasty: a clinical study in twenty-six patients.Scand J Plast Reconstr Surg. 1980; 14: 71-87
- Periosteal resurfacing of the metatarsal head in hallux rigidus and Frieberg's disease.J Orthop Rheum. 1992; 5: 79-84
Fuson SM, Lo EP. Reconstruction of the plantar plate: the flip-flop tenodesis. Paper presented at: American College of Foot and Ankle Surgeons Annual Meeting and Scientific Seminar; February 8–12, 2000; Miami, FL.
- The Cosentino modification for tendon interpositional arthroplasty.J Foot Ankle Surg. 1995; 34: 501-508
- Tendon arthroplasty of the first metatarsophalangeal joint in hallux rigidus: preliminary communication.Foot Ankle Int. 1997; 18: 222
- Soft-tissue arthroplasty for hallux rigidus.Foot Ankle Int. 2003; 24: 661-672
- Free gracilis interposition arthroplasty for severe hallux rigidus.Bull Hosp J Dis. 2005; 62: 121-124
- Disorders of the great toe.in: Regnauld B. The Foot: Pathology, Aetiology, Seminology, Clinical Investigation and Treatment. Springer-Verlag, Berlin1986: 345-359
- Subjective results of hallux rigidus following treatment with cheilectomy.Clin Orthop Relat Res. 1988; 226: 182-191
- How to write a systematic review.Clin Orthop Relat Res. 2007; 455: 23-29
- Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes.Foot Ankle Int. 1994; 15: 349-352
- Analysis of clinical grading scales for the foot and ankle.Foot Ankle Int. 1997; 18: 443-446
- Scoring in forefoot surgery: a statistical evaluation of single variables and rating systems.Acta Orthop Scand. 1998; 69: 498-504
- The problem with measuring patient perceptions of outcome with existing outcome measures in foot and ankle surgery.Foot Ankle Int. 2003; 24: 56-60
- Evaluation of the validity of AOFAS clinical rating systems by correlation to the SF-36.Foot Ankle Int. 2003; 24: 50-55
- A meta-analysis of outcome rating scales in foot and ankle surgery: is there a valid, reliable, and responsive system?.Foot Ankle Int. 2004; 25: 521-525
- Development and reliability of a standard rating system for outcome measurement of foot and ankle disorders I: development of standard rating system.J Orthop Sci. 2005; 10: 457-465
Article info
Publication history
Published online: March 29, 2010
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
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© 2010 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.
