title: Hemiarthroplasty and distal oblique first metatarsal osteotomy for hallux rigidus.
abstract: BACKGROUND
  In a retrospective study, we evaluated the effect of the addition of a decompressive osteotomy to hemiarthroplasty of the great toe in terms of clinical and radiographic outcomes.
  
  
  METHODS
  Twenty-one consecutive patients affected by Grade III hallux rigidus underwent distal oblique osteotomy of the first metatarsal and hemiarthroplasty of the hallux metatarsophalageal joint. Clinical evaluation included the American Orthopaedic Foot and Ankle Society scoring system (AOFAS) and the Short Form 36 questionnaire (SF-36), preoperatively and at followup visits. Standard weightbearing radiographs were performed to assess implant alignment, loosening, and bone loss. The mean followup was 26.4 (range, 16 to 29) months.
  
  
  RESULTS
  The mean AOFAS score improved from 47.5 ± 11.5 preoperatively to 76.0 ± 15.5 postoperatively (p < 0.01). At the last followup the SF-36 subscales Physical functioning, Bodily pain and Emotional role scores were increased from baseline. At the last followup, six patients (28.5%) were very satisfied with the outcome, ten patients (47.6%) were satisfied and five patients (23.8%) were dissatisfied. In the dissatisfied group, two patients had persistent joint pain with stiffness and subluxation of the prosthesis. Dorsal subsidence of the implant was present in ten patients at the last radiographic followup.
  
  
  CONCLUSIONS
  Hemiarthroplasty of the proximal phalanx and distal oblique metatarsal osteotomy for Grade III hallux rigidus at 2-years followup yielded mixed patient satisfaction and unsatisfactory radiographic outcome.
authors.affiliation: University Campus BioMedico - Rome, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Ronconi
authors.forename: Nicolò
authors.initials: N
authors.lastname: Martinelli
authors.forename: Francesco
authors.initials: F
authors.lastname: Cancilleri
authors.forename: Andrea
authors.initials: A
authors.lastname: Marinozzi
authors.forename: Gianluca
authors.initials: G
authors.lastname: Marineo
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Denaro
mesh_terms: D000368:Aged; D019643:Arthroplasty, Replacement / Q000379:methods*; D005260:Female; D020859:Hallux Rigidus / Q000145:classification / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008682:Metatarsal Bones / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D010027:Osteotomy; D017060:Patient Satisfaction; D011859:Radiography; D016896:Treatment Outcome