scholarly journals Percutaneous cheilectomy combined with Watermann and Moberg osteotomies for the treatment of hallux rigidus

2019 ◽  
Vol 13 (2) ◽  
pp. 135-139
Author(s):  
Júlio Ferreira de Arruda ◽  
André Donato Baptista
Keyword(s):  
Surgical Treatment ◽  
Range Of Motion ◽  
Functional Outcomes ◽  
Plantar Flexion ◽  
Case Series ◽  
Metatarsophalangeal Joint ◽  
Hallux Rigidus ◽  
Functional Improvement ◽  
Percutaneous Technique ◽  
Significant Difference

Objective: To evaluate the clinical and functional outcomes of patients subjected to surgical treatment of hallux rigidus by the percutaneous cheilectomy combined with Watermann and Moberg osteotomies. Methods: Between May 2017 and August 2018, the clinical outcomes of 7 patients with a diagnosis of hallux rigidus (HR) treated using the percutaneous technique were assessed using the American Orthopedic Foot and Ankle Society (AOFAS) scale, the visual analogue scale (VAS) for pain and hallux metatarsophalangeal joint range of motion measurements during the pre- and postoperative periods. Clinical and functional outcomes were followed up for a minimum of 6 months (mean of 8 months). Results: The range of motion of the metatarsophalangeal joint during the pre- and postoperative periods showed the following results: dorsiflexion increased on average from 28.00º (± 15.63) to 44.43º (± 17.33) (p = 0.006), demonstrating an effective gain in dorsal articular movement. Plantar flexion ranged on average from 27.43º (± 2.22) to 24.43º (± 5.28) (p = 0.228), with no significant difference between the evaluated periods. The AOFAS score increased on average from 52.71 (± 9.63) to 88.00 (± 8.10) (p < 0.01), representing important functional improvement. The VAS score decreased on average from 7.00 (± 1.52) to 2.14 (± 2.19) (p = 0.002), indicating a significant improvement in patient pain. No patient presented postoperative complications. Conclusion: The results of the present study demonstrated that cheilectomy combined with percutaneous Watermann and Moberg osteotomies is an effective surgical treatment for hallux rigidus, with satisfactory clinical and functional outcomes. Level of Evidence IV; Therapeutic Studies; Case Series.

Evaluation of Metatarsal Head Resurfacing Hemiarthroplasty in the Surgical Treatment of Hallux Rigidus: A Retrospective Study and Mid- to Long-Term Follow-up

2017 ◽  
Vol 11 (1) ◽  
pp. 22-31 ◽  
Author(s):  
Musa Uğur Mermerkaya ◽  
Erkan Alkan ◽  
Mehmet Ayvaz
Keyword(s):  
Surgical Treatment ◽  
Case Series ◽  
Metatarsophalangeal Joint ◽  
Metatarsal Head ◽  
Treatment Method ◽  
Hallux Rigidus ◽  
Retrospective Case ◽  
First Metatarsophalangeal Joint

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

scholarly journals Outcomes of Surgical Treatment of Talar Osteochondral Lesions using Bone Marrow Aspirate and Microgenized Allograft Cartilage Extra-cellular Matrix

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0021
Author(s):  
Robert Dekker ◽  
Milap Patel
Keyword(s):  
Bone Marrow ◽  
Surgical Treatment ◽  
Functional Outcomes ◽  
Bone Marrow Aspirate ◽  
Case Series ◽  
Cartilage Matrix ◽  
Osteochondral Lesions ◽  
Measurement Information ◽  
Significant Difference ◽  
Patient Reported

Category: Sports Introduction/Purpose: Osteochondral lesions (OCL) of the talus are frequently seen after ankle injury and often result in significant morbidity. Apart from a single case report, we are the first to present a case series of OCLs treated with bone marrow aspirate and micronized extracellular allograft cartilage matrix designed to serve as a scaffold to promote autologous healing. Short to mid-term outcomes using this technique are virtually absent in the literature. In this study, we sought to assess pre- and post-procedural functional outcomes using the validated Patient Reported Outcomes Measurement Information System (PROMIS) as well as assess cartilage incorporation on postoperative ankle MRI using the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) scoring. Methods: Twelve patients with symptomatic talar OCLs (14 lesions) were prospectively recruited. Average age was 44 years. Each underwent ankle arthroscopy, ankle arthrotomy, marrow stimulation and lesion repair using BMA and micronized extracellular allograft cartilage matrix by a single fellowship trained foot and ankle Orthopedic Surgeon. Preoperative, 6 month and 1 year postoperative PROMIS pain and function scores were collected prospectively. At six months, all patients underwent ankle MRI scans that were reviewed by a fellowship trained musculoskeletal radiologist for MOCART scoring. Results: No significant difference was detected between mean pre- and postoperative PROMIS function (41.4 vs 38.1; p=.54) and pain (61.3 vs 66.1) scores at 6 months. No significant difference was seen between mean pre- and postoperative PROMIS function (41.4 vs 41.8; p=.93) and pain (61.3 vs 58; p=.48) scores at 1 year. Mean postoperative MOCART score was 53.2 with a range of 5 to 90. Conclusion: Bone marrow aspirate and extracellular allograft cartilage matrix for surgical treatment of talar OCL showed no statistically significant improvement in functional outcomes at 6 months and 1 year. No correlation between functional outcomes and MOCART score was seen.

An Assessment of Hallux Limitus in University Basketball Players Compared with Noncompetitive Individuals

2014 ◽  
Vol 104 (5) ◽  
pp. 468-472 ◽  
Author(s):  
Paul Trégouët
Keyword(s):  
Range Of Motion ◽  
Metatarsophalangeal Joint ◽  
Hallux Rigidus ◽  
Artificial Turf ◽  
Basketball Players ◽  
First Metatarsophalangeal Joint ◽  
Hallux Limitus ◽  
Significant Difference ◽  
Turf Toe ◽  
The Difference

BackgroundInjuries of the first metatarsophalangeal joint have lately been receiving attention from researchers owing to the important functions of this joint. However, most of the studies of turf toe injuries have focused on sports played on artificial turf.MethodsThis study compared the range of motion of the first metatarsophalangeal joint in collegiate basketball players (n = 123) and noncompetitive individuals (n = 123).ResultsA statistically significant difference (P &lt; .001) in range of motion was found between the two groups. The difference between the two sample means was 21.35°.ConclusionsWith hallux rigidus being a potential sequela of repeated turf toe injuries, it seems likely that subacute turf toe injuries occur in basketball players, leading to degenerative changes that result in hallux limitus.

scholarly journals The effects of wearing high heeled shoes on the muscles and joints of lower limb

2021 ◽  
Vol 13 (1) ◽  
pp. 81-96
Author(s):  
Sema Polat ◽  
Ayşe Gül Kabakcı
Keyword(s):  
Lower Extremity ◽  
Range Of Motion ◽  
Tibialis Anterior ◽  
Muscle Force ◽  
Plantar Flexion ◽  
Tibialis Anterior Muscle ◽  
Metatarsophalangeal Joint ◽  
Heel Height ◽  
Lower Extremity Muscle ◽  
Significant Difference

Abstract Study aim: The aim of this study is to investigate whether the lower extremity muscles’ force/torque/strength and range of motion may be affected in females wearing high heeled shoes and not wearing high heeled shoes. Material and methods: The study was carried out with 136 females aged between 18 and 45 years. The first group consisted of 66 females wearing 5 cm or higher high heeled shoes. The second group consisted of 70 females wearing shoes having heel height less than 5 cm. The Nicholas Manual Muscle Tester was used to evaluate lower extremity muscle force/torque/strength, while range of motion was assessed with an electronic goniometer. The SPSS 21.0 program was used for statistical analysis. Results: A significant difference was found in the lower extremity muscles’ force (except for hip adduction, dorsiflexion, metatarsophalangeal joint and interphalangeal joint extension), and muscles’ torque (except for hip adduction, dorsiflexion and left tibialis anterior muscle) and muscles’ strength values (except for hip adduction, dorsiflexion and tibialis anterior muscle). Also, as heel height increased, the range of motion of hip joint flexion, internal rotation and plantar flexion increased significantly. Conclusions: Excessive use of high heeled shoes can cause changes in muscle force/torque/strength and joint range of motion.

Outcomes After Interpositional Arthroplasty of the First Metatarsophalangeal Joint

2017 ◽  
Vol 38 (5) ◽  
pp. 514-518 ◽  
Author(s):  
Michael C. Aynardi ◽  
Lara Atwater ◽  
Eric J. Dein ◽  
Talal Zahoor ◽  
Lew C. Schon ◽  
...  
Keyword(s):  
Case Series ◽  
Metatarsophalangeal Joint ◽  
Hallux Rigidus ◽  
Level Of Evidence ◽  
First Metatarsophalangeal Joint ◽  
Interpositional Arthroplasty ◽  
Significant Difference ◽  
Patient Reported ◽  
Functional Scores

Background: For patients with hallux rigidus seeking a motion-sparing procedure, interposition arthroplasty is an alternative to fusion. The purpose of this study was to report patient outcomes after interpositional arthroplasty for hallux rigidus. Methods: All patients undergoing interpositional arthroplasty at our institution from 2001 to 2014 were identified and a retrospective chart review was performed. Follow-up was conducted through a telephone survey to obtain survivorship, satisfaction, and functional scores. Survivorship of the interpositional arthroplasty procedure was defined as no subsequent surgery on the hallux after the index procedure. Patients were excluded for incomplete records. Complications were recorded. From 2001 to 2014, 183 patients were identified. Of these, 14 were excluded for incomplete data, leaving 169 patients. Of these, 133 had an average follow-up of 62.2 months (range, 24.3 months to 151.2 months). Results: The overall failure rate was 3.8% (5/133). Patient-reported outcome was rated as excellent in 65.4% (87/133) or good in 24.1% (32/133) of patients and fair or poor in 10.5% (14/133) of patients. Of 133 patients, 101 (76%) were able to return to fashionable or regular footwear. The infection rate was 1.5% (2/133). Patient-reported cock-up deformity of the first metatarsophalangeal joint (MTPJ) occurred in 4.5% (6/133) of patients. In addition, 17.3% (23/133) of patients reported metatarsalgia of the second or third MTPJ at the time of final follow-up, and there was no significant difference between interposition types ( P = .441). Conclusion: Interpositional arthroplasty for hallux rigidus was found to have excellent or good results in most patients at a mean follow-up of 62.2 months. Level of Evidence: Level IV, retrospective case series.

scholarly journals Treatment of End-Stage Hallux Rigidus and Impact of Arthrodesis versus Arthroplasty on Patient Reported Outcomes

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0001
Author(s):  
Monique Chambers ◽  
MaCalus Hogan ◽  
Dukens LaBaze
Keyword(s):  
Patient Reported Outcomes ◽  
Surgical Intervention ◽  
Metatarsophalangeal Joint ◽  
Hallux Rigidus ◽  
First Metatarsophalangeal Joint ◽  
Significant Difference ◽  
Patient Reported ◽  
Outcome Scores ◽  
Vas Scores ◽  
End Stage

Category: Bunion, Midfoot/Forefoot Introduction/Purpose: Hallux rigidus is a degenerative disease of the first metatarsophalangeal joint. Severe, end-stage hallux rigidus can become debilitating with surgical intervention becoming necessary once conservative measures and shoe modifications have failed. Joint salvage procedures include metatarsal phalangeal (MTP) arthrodesis and MTP arthroplasty. The purpose of this study was to assess for differences in patient reported outcomes in two cohorts who underwent fusion or joint reconstruction. Methods: This study was a retrospective review of prospectively collected data of 385 patients from an academic medical institution. Patients who underwent surgical intervention from July 2015 to November 2016 were identified based on CPT codes for MTP arthrodesis (28750) and arthroplasty (28293). We extracted outcome scores including SF12-M, SF12-P, FAAM, and VAS scores. Exclusion criteria included poly-trauma, revision procedures, and lack of pre and post-operative outcome scores. Mann- Whitney t-test was performed using GraphPad Prism version 7.0b for Mac to compare procedure groups, with significance define by a p-value of 0.05. Results: A total of eighteen patients met the inclusion criteria, with 6 who underwent arthroplasty and 12 arthrodesis. The average age was 63.7 amongst the cohort, with a total of 16 female and 2 males. Patients who underwent arthrodesis had better outcomes across all parameters. When comparing preoperative and postoperative scores, arthrodesis patients showed greater improvement of SF12-M (arthrodesis 9 vs arthroplasty -2, p=0.05), and SF12-P (9 vs -16, respectively p=0.05) scores. Arthroplasty patients were more likely to have a decrease in their SF-12 scores. VAS scores and FAAM scores showed no statistical difference between the two cohorts. Postoperative VAS scores were worse in 33% of arthroplasty patients despite surgical intervention, compared to 10% of arthrodesis patients. Conclusion: Our results suggests that both procedures provide a statistically significant difference in pain with several patients having a Global Rate of Change that is “very much better”. However, fusion of the metatarsophalangeal joint results in improved pain and functional outcomes for patients with severe hallux rigidus. These findings are consistent with current reports in the literature, which are mostly case series reports. Larger studies are needed to provide appropriate power and better support the findings of this study.

One-year Follow-Up Results with Hydrogel Implant in Therapy of Hallux Rigidus: Case Series with 44 Patients

2021 ◽  
Author(s):  
Christoph Zanzinger ◽  
Norbert Harrasser ◽  
Oliver Gottschalk ◽  
Patrick Dolp ◽  
Florian Hinterwimmer ◽  
...  
Keyword(s):  
Learning Algorithm ◽  
Case Series ◽  
Metatarsophalangeal Joint ◽  
Hallux Rigidus ◽  
Therapy Failure ◽  
Retrospective Case ◽  
Aofas Score ◽  
Medium Level ◽  
One Year

Abstract Background The Cartiva implant (CI) is being increasingly used in the surgical therapy of hallux rigidus. Despite a growing number of studies, numerous questions regarding patient selection remain unanswered. Patients and Methods As part of a retrospective case series with prospective follow-up (average follow-up period: 12 months), a total of 44 patients (male/female = 16/28; mean age at the time of surgery: 55.4 years) with 44 CI were analysed (VAS, EFAS-, AOFAS-score). Using a correlation analysis and a machine learning algorithm, risk factors for therapy failure were investigated. Results The overall survival rate of the CI was 93% at 12 months. The VAS, EFAS and AOFAS scores showed a significant improvement in comparison to the preoperative condition. The mobility of the metatarsophalangeal joint showed no increase. Patients with a medium osteoarthritis grade and a medium level of clinical restraint showed the greatest improvement in relation to their preoperative condition. Conclusion The CI can be seen as an effective therapy for hallux rigidus. Nonetheless, realistic patient expectations must be communicated.

scholarly journals Treatment of hallux rigidus with percutaneous arthrodesis

2018 ◽  
Vol 12 (2) ◽  
pp. 90-95
Author(s):  
Vitor Baltazar Nogueira ◽  
Miguel Viana Pereira Filho ◽  
Mauro Cesar Mattos e Dinato ◽  
Márcio De Faria Freitas ◽  
Rodrigo Gonçalves Pagnano
Keyword(s):  
Medical Records ◽  
Case Series ◽  
Metatarsophalangeal Joint ◽  
Conventional Technique ◽  
Hallux Rigidus ◽  
Time Level ◽  
First Metatarsophalangeal Joint ◽  
The Mean ◽  
Pain Improvement ◽  
Consolidation Time

Objective: The objective of this study was to describe the percutaneous arthrodesis technique with single medial portal of the first metatarsophalangeal joint and to evaluate the results of a series of nine cases (10 feet) with a diagnosis of hallux rigidus subjected to this technique, comparing the results with literature data regarding the conventional technique. Methods: This was a retrospective, observational study performed by analysis of medical records and radiographs of nine patients undergoing percutaneous arthrodesis of the hallux metatarsophalangeal joint. Gender, age, consolidation time, level of postoperative pain and degree of patient satisfaction were evaluated. Results: Eight patients were female, and one patient was male. The mean age was 68.7 years, the mean consolidation time was 8 weeks, the consolidation ratio was 70%, there was pain improvement in the postoperative period, and all patients considered themselves satisfied with the surgery. Conclusion: Percutaneous arthrodesis of the metatarsophalangeal hallux joint potentially yields results similar to those of the conventional method demonstrated in the literature but uses smaller incisions.Level of Evidence IV, Therapeutic Studies, Case Series.

scholarly journals Effect of mobilization on ankle mobility and balance performance in diabetic patients

Biomedicine ◽  
2020 ◽  
Vol 39 (2) ◽  
pp. 305-309
Author(s):  
Albin Jerome ◽  
Karthikeyan Jeyabalan ◽  
Hoe Kean Keong ◽  
Gaurai Gharote
Keyword(s):  
Range Of Motion ◽  
Conventional Treatment ◽  
Plantar Flexion ◽  
Joint Mobility ◽  
Functional Reach ◽  
Significant Difference ◽  
Functional Reach Test ◽  
Diabetic Population ◽  
Experimental Group ◽  
Ankle Plantar Flexion

Introduction and Aim: Diabetic Cheiroarthropathy is defined as the condition of restriction joint mobility due to pseudo-sclerodermatous hand, the fibrosis of the elastin connective tissues over the skin. It limits joint mobility especially around Tibia fibular mobility that are interrelated with the flexibility of ankle motion that results in the balance disorder in diabetic population. The aim of the study was to determine the effects of the tibia fibular mobilization technique on ankle joint in diabetes mellitus patients. Materials and Methods: 60 diabetic subjects were randomly assigned into experimental group and control, in which experimental group received Tibia fibular mobilization technique and conventional treatment whereas control group received only conventional treatment 1 time a week for 3 weeks. Results: There is no significant difference in Ankle dorsi flexion range of motion in both extremities but there is significant difference in ankle plantar flexion range of motion in both extremities and functional reach test in both extremities. Conclusion: There is a significant difference in the ankle plantar flexion range of motion and functional reach test, Hence, mobilization of Tibiofibular joint will be beneficial in improving the ankle range of motion and balance factor in the diabetic population.  

scholarly journals Surface Replacement Proximal Interphalangeal Joint Arthroplasty: A Case Series

Hand ◽  
2018 ◽  
Vol 14 (5) ◽  
pp. 669-674
Author(s):  
Pieter W. Jordaan ◽  
Duncan McGuire ◽  
Michael W. Solomons
Keyword(s):  
Patient Satisfaction ◽  
Range Of Motion ◽  
Retrospective Review ◽  
Case Series ◽  
Proximal Interphalangeal Joint ◽  
Joint Arthroplasty ◽  
Interphalangeal Joint ◽  
Surface Replacement ◽  
Significant Difference

Background: In 2012, our unit published our experience with a pyrocarbon proximal interphalangeal joint (PIPJ) implant. Due to high subsidence rates, a decision was made to change to a cemented surface replacement proximal interphalangeal joint (SR-PIPJ) implant. The purpose of this study was to assess whether the change to a cemented implant would improve the subsidence rates. Methods: Retrospective review of all patients who had a cemented SR-PIPJ arthroplasty performed from 2011 to 2013 with at least 12 months follow-up. Results: A total of 43 joints were included with an average follow-up of 26.5 months. There was a significant ( P = .02) improvement in arc of motion with an average satisfaction score of 3.3 (satisfied patient). Subsidence was noted in 26% of joints with a significant difference in range of motion ( P = .003) and patient satisfaction ( P = .001) between the group with and without subsidence. Conclusions: The change to a cemented implant resulted in satisfied patients with an improvement in range of motion. The rate of subsidence improved but remains unacceptably high.

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