The treatment of advanced hallux rigidus remains controversial. Only a few studies have analyzed the short- and mid-term results of metatarsophalangeal (MTP) joint arthroplasty to treat patients with advanced hallux rigidus. We present the short-term follow-up results of patients who underwent MTP joint arthroplasty. We reviewed the medical records of 15 consecutive patients (3 males and 12 females) who had had grade 3 or 4 hallux rigidus diagnosed according to the Coughlin and Shurnas classification. The age range at surgery was 44 to 74 (mean 61.6) years. The mean follow-up period was 21.7 (range 18 to 28) months. The mean change in the overall American Orthopaedic Foot and Ankle Society Hallux-First Ray scale score was from 26.9 ± 2.3 preoperatively to 78.7 ± 8.8 postoperatively (p < .005). The mean change in the overall visual analog scale score was from 8.3 ± 0.8 preoperatively to 1.7 ± 0.7 postoperatively (p < .005). The mean preoperative first MTP joint range of motion was 22.3° ± 7.7° (range 15° to 45°), which had increased to 77° (range 65° to 90°) at the final follow-up visit. No patient required revision surgery or removal. These results indicate that for patients with advanced-stage hallux rigidus refractory to conservative treatment, total joint arthroplasty can lead to good satisfaction and good functional results in the short term.
Level of Clinical Evidence
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- Contraction of the metatarsophalangeal joint of the great toe.BMJ. 1887; 1: 72
- What’s new in surgical options for hallux rigidus?.J Bone Joint Surg Am. 2004; 86-A: 72-83
- Quantitative review ofoperative management of hallux rigidus.Br Med Bull. 2011; 98: 75-98
- A simple operation for hallux rigidus.Clin Orthop Relat Res. 1979; 142: 55-56
- Subjective results of hallux rigidus following treatment with cheilectomy.Clin Orthop Relat Res. 1988; 226: 182-191
- Hallux rigidus: grading and long-term results of operative treatment.J Bone Joint Surg Am. 2003; 85-A: 2072-2088
- First metatarsophalangeal joint replacement with total arthroplasty in the surgical treatment of the hallux rigidus.Acta Biomed. 2014; 85: 113-117
- Resurfacing of the first metatarsal head in the treatment of hallux rigidus.Tech Foot Ankle Surg. 2008; 7: 31-40
- Outcomes after interpositional arthroplasty for treatment of hallux rigidus.Clin Orthop Relat Res. 2006; 445: 210-215
- Arthrodesis of the metatarsophalangeal joint of the great toe.Clin Orthop Relat Res. 1981; 157: 70-77
- Current treatment methods in hallux rigidus.TOTBID J. 2006; 5: 95-100
- Current concepts review: hallux rigidus.Foot Ankle Int. 2008; 29: 637-646
- Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes.Foot Ankle Int. 1994; 15: 349-353
- Reliability and validity of the subjective component of the American Orthopedic Foot and Ankle Society clinical rating scales.J Foot Ankle Surg. 2007; 46: 65-74
- Reliability and responsiveness of three different pain assessments.J Rehabil Med. 2001; 33: 279-283
- Metatarsophalangeal joint measurement.in: Karter K. Measurement of Joint Motion—A Guide to Goniometry. ed 4. FA Davis, Philadelphia2009
- Capsular interposition arthroplasty for severe hallux rigidus.Foot Ankle Int. 1997; 18: 68-70
- Hallux rigidus: cheilotomy or implant?.Foot Ankle. 1981; 1: 315-320
- Orthotic management for disorders of the hallux.Foot Ankle Clin. 2005; 10: 191-209
- Comparison of arthrodesis and metallic hemiarthroplasty of the hallux metatarsophalangeal joint.J Bone Joint Surg Am. 2007; 89: 1979-1985
- A retrospective review of immediate weightbearing after first metatarsophalangeal joint arthrodesis.Foot Ankle Spec. 2008; 1: 24-28
- Cost comparison of crossed screws versus dorsal plate construct for first metatarsophalangeal joint arthrodesis.J Foot Ankle Surg. 2008; 47: 13-18
- First metatarsophalangeal arthrodesis using a dorsal plate and a compression screw.Foot Ankle Int. 2010; 31: 797-801
- Keller resection arthroplasty: a 13-year experience.Foot Ankle Int. 1991; 11: 187-194
- Reduced postoperative functional length ratio influences patient satisfaction in first metatarsophalangeal joint replacement.J Foot Ankle Surg. 2016; 55: 743-747
- Combined rotation scarf and Akin osteotomies for hallux valgus: a patient-focused 9-year follow-up of 50 participants.J Foot Ankle Res. 2010; 15: 2
- Early results of first metatarsophalangeal joint replacement using the ToeFit-Plus™ prosthesis.J Foot Ankle Surg. 2014; 53: 265-268
- Early failure of the Moje screw-fit ceramic metatarsophalangeal joint replacement.Foot. 2003; 13: 204-208
- Second-generation ceramic first metatarsophalangeal joint replacement for hallux rigidus.Foot Ankle Int. 2014; 35: 690-698
- Outcome following first metatarsophalangeal joint replacement using TOEFIT-PLUS™: a mid-term alert.Foot Ankle Surg. 2015; 21: 119-124
- First metatarsophalangeal joint replacement: long-term results of a double-stemmed flexible silicone prosthesis.Foot Ankle Surg. 2011; 17: 224-227
- Meta-analysis of first metatarsophalangeal joint implant arthroplasty.J Foot Ankle Surg. 2009; 48: 180-190
Published online: June 27, 2017
Financial Disclosure: None reported.
Conflict of Interest: None reported.
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