title: Replacement arthroplasty of the first metatarsophalangeal joint using a ceramic-coated endoprosthesis for the treatment of hallux rigidus.
abstract: We prospectively assessed 40 patients who underwent total first metatarsophalangeal joint replacement arthroplasty using a ceramic implant for the treatment of hallux rigidus. A total of 42 toes in 40 patients were included in the assessment. Preoperatively, the mean American Orthopaedic Foot and Ankle Society (AOFAS) hallux first metatarsal score was 36.00 +/- 10.79 points, and first metatarsophalangeal joint range of motion was 4.9 degrees +/- 5.52 degrees . The mean preoperative AOFAS score increased from 36.00 +/- 10.79 to 82.20 +/- 9.54 at 3 months (P < .001), to 87.00 +/- 10.62 at 12 months, and to 84.20 +/- 10.69 at 24 months. There was no statistically significant change in scores from 3 months onward. Range of motion increased to 70.80 degrees +/- 15.97 degrees in the operating room and reduced to 45.60 degrees +/- 12.28 degrees at 3 months postoperative, decreasing to 40.00 degrees +/- 12.72 degrees at 12 months and 33.30 degrees +/- 17.19 degrees at 24 months postop. We advocate total toe arthroplasty with this all-ceramic press-fit implant as an effective procedure for the treatment of moderate to severe hallux rigidus. This ceramic, total first metatarsophalangeal joint endoprosthesis yields good improvement in foot-related quality-of-life scores, reasonable range of motion, and a low early revision rate.
authors.affiliation: Department of Trauma and Orthopaedics, Worcestershire Hospitals NHS Trust, West Midlands, UK. Jamie@arbuthnot.me.uk
authors.forename: James E
authors.initials: JE
authors.lastname: Arbuthnot
authors.forename: Graham
authors.initials: G
authors.lastname: Cheung
authors.forename: Birinder
authors.initials: B
authors.lastname: Balain
authors.forename: Tracey
authors.initials: T
authors.lastname: Denehey
authors.forename: Gordon
authors.initials: G
authors.lastname: Higgins
authors.forename: Michael C
authors.initials: MC
authors.lastname: Trevett
mesh_terms: D000328:Adult; D000368:Aged; D001696:Biomechanical Phenomena; D002516:Ceramics; D005260:Female; D020859:Hallux Rigidus / Q000601:surgery*; D006801:Humans; D007595:Joint Prosthesis; D008297:Male; D008683:Metatarsophalangeal Joint / Q000601:surgery*; D008875:Middle Aged; D019637:Orthopedic Procedures; D011446:Prospective Studies; D016059:Range of Motion, Articular