Comparison of two different total joint replacement and arthrodesis treatments for advanced hallux rigidus: Shortterm functional outcomes
Comparison of two different total joint replacement and arthrodesis treatments for advanced hallux rigidus: Shortterm functional outcomes
Aim: Hallux rigidus is osteoarthritis of the big toe and is a clinical tableau with progressive pain and movement loss. This studyaims to present the clinical outcomes of patients with grade 3 and 4 hallux rigidus unresponsive to conservative treatment who hadarthroplasty with two different metallic implants or arthrodesis and to compare the outcomes of these treatments.Material and Method: Forty patients with arthroplasty or arthrodesis surgery due to hallux rigidus performed by a single surgeonfrom 2013 to 2018 were retrospectively compared in terms of AOFAS, VAS and ROM measurements and functional scores.Results: When the clinical outcomes of patients with arthroplasty are compared, there was no statistically significant differenceobserved. When the arthrodesis group is compared with the arthroplasty groups, separately and combined, there was no statisticallysignificant differences observed in terms of functional scores.Conclusion: Total joint arthroplasty performed on the big toe offers patients the possibility of a painless metatarsalphalangeal joint(MTPJ) without movement limitations or high complication rates. Arthrodesis is still the most reliable surgical salvage procedure;however, it should be chosen for use as a salvage procedure for stage hallux rigidus that is advanced in terms of function, as withother joints in the musculoskeletal system.
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- 1. Ho B, Baumhauer J. Hallux rigidus. EFORT Open Rev
2017;13;2:13-20.
- 2. Brage ME, Ball ST. Surgical options for salvage of end-stage
hallux rigidus. Foot Ankle Clin North Am 2002;7:49-73.
- 3. Gianini S, Ceccarelli F, Faldini C, et al. What’s new in
surgical options for hallux rigidus? J Bone Joint Surg Am
2004;86A:72-83.
- 4. Shereff MJ, Bejjani FJ, Kummer FJ. Kinematics of the first
metatarsophalangeal joint. J Bone Joint Surg [Am] 1986;68-
A:392-8.
- 5. Ibrahim T, Beiri A, Azzabi M, et al. 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.
- 6. Kitaoka HB, Alexander IJ, Adelaar RS, et al. Clinical rating
systems for the ankle-hindfoot, midfoot, hallux, and lesser
toes. Foot Ankle Int 1994;15:349-53.
- 7. Coughlin MJ, Shurnas PS. Hallux rigidus: demographics,
etiology, and radiographic assessment. Foot Ankle Int
2003;24:731-43.
- 8. Valentini R, De Fabrizio G, Piovan G. First metatarsophalangeal
joint replacement with total arthroplasty in the surgical
treatment of the hallux rigidus. Acta Biomed 2014;85:113-7.
- 9. Hasselman CT, Shields N. Resurfacing of the first metatarsal
head in the treatment of hallux rigidus. Tech Foot Ankle Surg
2008;7:31-40.
- 10. Kennedy JG, Chow FY, Dines J, et al. Outcomes after
interpositional arthroplasty for treatment of hallux rigidus.
Clin Orthop Relat Res 2006;445:210-5.
- 11. Gibson JN, Thomson CE. Arthrodesis or total replacement
arthroplasty for hallux rigidus: a randomized controlled trial.
Foot Ankle Int 2005;26:680-90.
- 12. Hamilton WG, O’Malley MJ, Thompson FM, et al. Capsular
interposition arthroplasty for severe hallux rigidus. Foot
Ankle Int 1997;18:68-70.
- 13. Gould N. Hallux rigidus: cheilotomy or implant? Foot
Ankle1981;1:315-20.
- 14. Sammarco VJ, Nichols R. Orthotic management for
disorders of the hallux. Foot Ankle Clin 2005;10:191-209.
- 15. Coughlin MJ, Shurnas PS. Hallux rigidus: grading and longterm
results of operative treatment. J Bone Joint Surg Am
2003;85A:2072-88.
- 16. Yetkin H, Kanatlı U, Song€ur M. Current treatment methods
in hallux rigidus. TOTBID J 2006;5:95-100 .
- 17. Fitzgerald JA, Wilkinson JM. Arthrodesis of the
metatarsophalangeal joint of the great toe. Clin Orthop Relat
Res 1981;157:70-7.
- 18. Brage ME, Ball ST. Surgical options for salvage of end-stage
hallux rigidus. Foot Ankle Clin 2002;7:49-73.
- 19. Dawson-Bowling S, Adimonye A, Cohen A, et al. MOJE
ceramic metatarsophalangeal arthroplasty: disappointing
clinical results at two to eight years. Foot Ankle Int.
2012;33:560-4.
- 20. Nixon NF, Taylor GJS. Early failure of the Moje implant when
used to treat hallux rigidus: the need for regular surveillance.
Foot 2008;18:1-6.
- 21. Cook E, Cook J, Rosenblum B, et al. Meta-analysis of first
metatarsophalangeal joint implant arthroplasty. J Foot
Ankle Surg 2009;48:180-90.
- 22. Barwick TW, Talkhani IS. The MOJE total joint arthroplasty
for 1st metatarsophalangeal osteoarthritis: a short-term
retrospective outcome study. Foot (Edinb) 2008;18:150-5.
- 23. McGraw IW, Jameson SS, Kumar CS. Mid-term results
of the Moje hallux MP joint replacement. Foot Ankle Int
2010;31:592-9.
- 24. Pulavarti RS, McVie JL, Tullochn CJ. First
metatarsophalangeal joint replacement using the Bio-
Action great toe implant: intermediate results. Foot Ankle
Int 2005;26:1033-7.
- 25. Raikin SM, Ahmad J, Pour AE, et al. Comparison of
arthrodesis and metallichemiarthroplasty of the hallux
metatarsophalangeal joint. J Bone Joint Surg Am
2007;89:1979-85.
- 26. Sevimli R, Aslantürk O, Ergen E, et al. Mid-Term Outcomes
of Arthroscopic Treatment in Patients with a Stiff Elbow.
Cureus. 2018;10:e2630
- 27. Sevimli R, Karakaplan M, Korkmaz MF, et al. Resection
Arthroplasty in shoulder joint tuberculosis: a case
presentation. Gavin J Case Rep 2016:7-9.
- 28. Heller WA, Brage ME. The effects of cheilectomy on
dorsiflexion of the first metatarsophalangeal joint. Foot
Ankle Int 1997;18:803-8.
- 29. Erdil M, Elmadağ NM, Polat G, et al. Comparison of
arthrodesis, resurfacing hemiarthroplasty, and total joint
replacement in the treatment of advanced hallux rigidus.
Foot Ankle Surg 2013;52:588-93.