Long-term outcome of first metatarsophalangeal joint fusion in the treatment of severe hallux rigidus

Background. The aim of this study was to evaluate the mid- to long-term outcomes of metatarsal head resurfacing hemiarthroplasty in the surgical treatment of advanced-stage hallux rigidus. Methods. We performed a retrospective review of 57 consecutive patients (25 [43.9%] males, 32 [56.1%] females; mean age, 61.0 ± 6.4 years) who underwent first metatarsal head resurfacing hemiarthroplasty (HemiCAP) for hallux rigidus between August 2007 and September 2010. Sixty-five implantations were performed in 57 patients; 8 patients underwent bilateral procedures. All patients were clinically rated prior to surgery and at the final follow-up visit using the American Orthopaedic Foot and Ankle Society (AOFAS) hallux metatarsophalangeal-interphalangeal scale and first metatarsophalangeal joint range of motion (MTPJ ROM). Results. The median follow-up duration was 81 (range = 8-98) months. The median preoperative AOFAS score was 34 (range = 22-59) points, which had increased to 83 (range = 26-97) points at the final follow-up visit (P < .001). The median preoperative first MTPJ ROM was 25° (range = 15° to 40°), which had increased to 75° (range = 30° to 85°) at the final follow-up visit (P < .001). Conclusions. First MTPJ hemiarthroplasty is an effective treatment method that recovers toe function and first MTPJ ROM, and provides good mid- to long-term functional outcomes. Levels of Evidence: Level IV: Retrospective case series

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Arthrodesis of the First Metatarsophalangeal Joint

Journal of the American Podiatric Medical Association ◽

10.7547/1020013 ◽

2012 ◽

Vol 102 (1) ◽

pp. 13-17 ◽

Cited By ~ 10

Author(s):

Kalpesh Shah ◽

Angelica Augustine ◽

Robert Carter ◽

Angus McFadyen

Keyword(s):

Interobserver Reliability ◽

Metatarsophalangeal Joint ◽

Hallux Rigidus ◽

First Metatarsophalangeal Joint ◽

Lag Screw ◽

Fixation Group ◽

Joint Fusion ◽

Bone Fragments ◽

The Mean ◽

Mean Time

Background: There are cadaveric and biomechanical studies comparing different methods of fixation for achieving arthrodesis in hallux rigidus. However, there are no comparative clinical studies. We compared the clinical and radiologic outcomes of first metatarsophalangeal joint fusion using three different techniques: lag screw, lag screw and circlage wire, and Memory staples. Methods: This was a retrospective study of 46 patients who underwent first metatarsophalangeal joint fusion. All of the operations were performed by experienced surgeons. Each patient had clinical and radiologic assessments postoperatively. Results: The three groups were matching in terms of demographic features and comorbidity. Intraobserver and interobserver reliability for radiographic metatarsophalangeal joint fusion was excellent. The mean time to clinical and radiologic union in the Memory staples group was earlier (7.6 weeks) than that of the other two techniques (8.0 and 8.1 weeks). The Memory staples group also had the lowest incidence of nonunion (1 of 15 compared with 4 of 15 in the single lag screw fixation group and 3 of 16 in the lag screw and circlage wire fixation group) and no hardware-related problems. Conclusions: Our experience corroborates the advantages of Memory staples as described in the literature, including good approximation of bone fragments, technically easy application with fewer steps than an AO-applied screw, and an adequate source of internal fixation to achieve metatarsophalangeal joint fusion. There is also a suggestion that the time to achieve fusion is shorter. (J Am Podiatr Med Assoc 102(1): 13-17, 2012)

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Cone Arthrodesis of the First Metatarsophalangeal Joint

Foot & Ankle ◽

10.1177/107110078400400505 ◽

1984 ◽

Vol 4 (5) ◽

pp. 244-248 ◽

Cited By ~ 64

Author(s):

J. E. Johansson ◽

T. W. Barrington

Keyword(s):

Average Length ◽

Metatarsophalangeal Joint ◽

Valgus Deformity ◽

Hallux Rigidus ◽

Long Term Results ◽

First Metatarsophalangeal Joint ◽

Hallux Valgus Deformity ◽

Metatarsophalangeal Joints

The reliability and effectiveness of the treatment of hallux rigidus and sympomatic arthritis of the first metatarsophalangeal joint by the technique of cone arthrodesis are discussed. The authors reviewed the long-term results of cone arthrodesis in 51 patients with 60 operated feet. The average age was 55 years (range, 28 to 75 years) and the average length of follow-up was 39 months (range, 1 to 12 years). On questioning the patients regarding function, cosmesis, and pain, 41 of 51 patients were happy, eight of 51 patients were satisfied, and two of 51 were unhappy with their feet. No patient complained of persistent or recurrent hallux valgus deformity. Radiologically and clinically 58 of 60 first metatarsophalangeal joints were solidly fused. Two patients had a fibrous ankylosis which was functional and painless. Function with respect to gait and ability to walk on tiptoe and run was normal in all patients. In summary, the authors feel that this procedure is a reliable, effective treatment of painful arthritis of this joint.

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Long-term results of first metatarsophalangeal joint fusion for severe hallux valgus deformity

Foot and Ankle Surgery ◽

10.1046/j.1460-9584.2001.00229.x ◽

2001 ◽

Vol 7 (1) ◽

pp. 9-13 ◽

Cited By ~ 14

Author(s):

Z. Agoropoulos ◽

N. Efstathopoulos ◽

J. Mataliotakis ◽

C. Kokoroghiannis ◽

G.G. Karachalios ◽

...

Keyword(s):

Hallux Valgus ◽

Metatarsophalangeal Joint ◽

Valgus Deformity ◽

Long Term Results ◽

First Metatarsophalangeal Joint ◽

Joint Fusion ◽

Hallux Valgus Deformity ◽

Severe Hallux Valgus

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Percutaneous First Metatarsophalangeal Joint Fusion

The Open Orthopaedics Journal ◽

10.2174/1874325001711010724 ◽

2017 ◽

Vol 11 (1) ◽

pp. 724-731 ◽

Cited By ~ 3

Author(s):

Thomas Bauer

Keyword(s):

Simple Procedure ◽

Weight Bearing ◽

Metatarsophalangeal Joint ◽

Hallux Rigidus ◽

Full Weight Bearing ◽

Normal Walking ◽

First Metatarsophalangeal Joint ◽

Joint Fusion ◽

Forefoot Surgery ◽

First Ray

The first metatarsophalangeal (MTP1) joint fusion is a very useful procedure in forefoot surgery and is still the gold standard for the treatment of severe and painful hallux rigidus. Normal walking and running are possible after MTP1 fusion, the first ray mobility being essentially in the interphalangeal (IP) joint with a compensatory hypermobility in dorsal flexion. Percutaneous MTP1 fusion is a simple procedure providing comparable results to fusions performed with open techniques. Postoperative cares are simplified with an immediate full weight bearing on rigid flat shoes and quick return to normal walking. Bone preparation is an important step and requires an experience in percutaneous forefoot surgery. Arthrodesis positioning and fixation with this percutaneous procedure are simple with possibility of clinical and radiological control. The indications for percutaneous MTP1 fusion are very large and only severe bone loss or osteoporosis represent the limits for this technique.

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Long-term functional results of first metatarsophalangeal joint arthrodesis for hallux rigidus

Genij Ortopedii ◽

10.18019/1028-4427-2020-26-1-30-36 ◽

2020 ◽

Vol 26 (1) ◽

pp. 30-36

Author(s):

D.V. Ilchenko ◽

◽

A.V. Korolev ◽

A.A. Kardanov ◽

◽

...

Keyword(s):

Metatarsophalangeal Joint ◽

Functional Results ◽

Hallux Rigidus ◽

First Metatarsophalangeal Joint

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Management of a failed metatarso-phalangeal joint fusion utilizing a hemicup prosthesis

Clinics and Practice ◽

10.4081/cp.2014.646 ◽

2014 ◽

Vol 4 (2) ◽

Cited By ~ 2

Author(s):

Nicola Stadler ◽

Stefan Hofstätter ◽

Klemens Trieb

Keyword(s):

Case Report ◽

Metatarsophalangeal Joint ◽

Treatment Method ◽

Hallux Rigidus ◽

Salvage Procedure ◽

Operative Techniques ◽

First Metatarsophalangeal Joint ◽

First Report ◽

Joint Fusion

We report a case of a 65-year-old man with a painful nonunion of the first metatarsophalangeal joint (MTPJ). It is one of the main severe complications of this surgery. Its prevalence is described between 5% and 10% across different operative techniques. The implantation of hemicup-prosthesis has been successfully used for the hallux rigidus treatment with very promising results. In our case report, we introduce a treatment method of converting a pseudoarthrosis of the first MTPJ, made of two crossing screws into a hemicup-prosthesis as a salvage procedure. This is to our best knowledge the first report using this device for treatment of pseudoarthrosis of the first MTPJ.

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Management of Hallux Limitus with Distraction of the First Metatarsophalangeal Joint

Journal of the American Podiatric Medical Association ◽

10.7547/0950121 ◽

2005 ◽

Vol 95 (2) ◽

pp. 121-129 ◽

Cited By ~ 19

Author(s):

Leonard M. Talarico ◽

George R. Vito ◽

Larry Goldstein ◽

Adam D. Perler

Keyword(s):

External Fixator ◽

Metatarsophalangeal Joint ◽

Hallux Rigidus ◽

Long Term Results ◽

Joint Function ◽

First Metatarsophalangeal Joint ◽

Hallux Limitus

This article describes a joint-preserving and joint-restoring procedure for the management of hallux limitus and hallux rigidus. The procedure uses a minirail external fixator to obtain distraction with or without arthrotomy of the first metatarsophalangeal joint. This procedure aims to restore joint function through elimination of the pathologic forces involved in hallux limitus and hallux rigidus. Both intrinsic and extrinsic muscular imbalances are reduced. Follow-up of 133 patients treated in this manner since 1997 demonstrates excellent long-term results. (J Am Podiatr Med Assoc 95(2): 121–129, 2005)

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