Abstract
The treatment of advanced hallux rigidus remains controversial, with many authors
discussing arthrodesis versus arthroplasty. The purpose of this study is to report
mid-term outcomes after implantation of a motion-preserving metatarsal head–resurfacing
prosthetic and to present our technical considerations and modifications to the published
technique to further enhance the clinical benefit of the procedure. Thirty-two implantations
were performed in 30 patients. Twenty-three patients were women, 9 men. The average
age was 62.8 years (range, 39-86 years). Patients were graded at baseline according
to Hattrup and Johnson and completed the American Orthopaedic Foot & Ankle Surgery
metatarsophalangeal clinical rating system preoperatively and postoperatively and
a patient satisfaction question at final follow-up. Seventy-two percent of implantations
were grade III hallux rigidus and 28% were grade II. The average follow-up was 27.3
months (range, 12-43 months). The mean change score for the overall American Orthopaedic
Foot & Ankle Surgery scale was 236.8% (SD = 146.62, confidence interval [CI] = 186-287.6).
A similar result was achieved between grade II (250.9%, SD = 240.3, CI = 93.9-407.9)
and grade III (231.3%, SD = 95.83, CI = 195.14-270.46). No implants were revised or
removed, and all patients stated that they were happy with their outcome and would
repeat the procedure again if needed. In conclusion, metatarsal head resurfacing in
combination with joint decompression, soft tissue mobilization, and debridement can
achieve excellent results in grade II and III hallux rigidus. Salvage arthrodesis
remains an option if future revisions are indicated.
Level of Clinical Evidence
Keywords
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Article info
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
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Copyright
© 2010 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.
