title: A multicenter retrospective review of outcomes for arthrodesis, hemi-metallic joint implant, and resectional arthroplasty in the surgical treatment of end-stage hallux rigidus.
abstract: This is a retrospective, multicenter study examining the long-term results for the treatment of end-stage hallux rigidus using 3 different surgical procedures. A total of 158 subjects (105 females and 53 males) were included in the present study. They had undergone 1 of the following surgical procedures: arthrodesis, hemi-implant, or resectional arthroplasty. The long-term results for the subjective assessment of pain, function, and alignment, as well as objective radiographic and physical findings, were examined. The median interval to postoperative follow-up for the 3 procedure groups was 159 weeks. No statistically significant difference was found in age or the number of subjects included in the 3 treatment groups (p = .11 and p = .16, respectively). The body mass index was significantly different statistically among the 3 treatment groups, with the hemi-implant group representing a smaller body mass index compared with the other procedures (p = .007). No statistically significant difference was found in the subjective outcomes among the 3 treatment groups using the American College of Foot and Ankle Surgeons' First Metatarsophalangeal Joint and First Ray Scoring Scale (patient questionnaire) or the modified Hallux Metatarsophalangeal-Interphalangeal Scale of the American Orthopedic Foot and Ankle Society (p = .64 and p = .14, respectively). Furthermore, the correlation coefficient between the 2 subjective scoring scales was 0.78, statistically significant and reflecting a moderate to high correlation (p < .001). The results of the radiographic and clinical evaluation revealed that metatarsalgia was the most common finding for the arthrodesis group (9.8%), bony overgrowth into the joint for the hemi-implant group (28.3%), and floating hallux for the resectional arthroplasty group (30.9%). The results of our study suggest that all 3 surgical procedures are viable options for the treatment of end-stage hallux rigidus.
authors.affiliation: Associate Professor, Department of Plastic Surgery, Georgetown University Hospital, Washington, DC 20007-0469, USA. paul.j.kim@gunet.georgetown.edu
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Kim
authors.forename: Daniel
authors.initials: D
authors.lastname: Hatch
authors.forename: Lawrence A
authors.initials: LA
authors.lastname: Didomenico
authors.forename: Michael S
authors.initials: MS
authors.lastname: Lee
authors.forename: Bruce
authors.initials: B
authors.lastname: Kaczander
authors.forename: Gary
authors.initials: G
authors.lastname: Count
authors.forename: Marc
authors.initials: M
authors.lastname: Kravette
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018771:Arthralgia / Q000209:etiology; D001174:Arthrodesis; D001178:Arthroplasty / Q000379:methods*; D019643:Arthroplasty, Replacement; D015992:Body Mass Index; D005260:Female; D020859:Hallux Rigidus / Q000601:surgery*; D006801:Humans; D007595:Joint Prosthesis; D008297:Male; D037061:Metatarsalgia / Q000209:etiology; D008683:Metatarsophalangeal Joint / Q000601:surgery; D008875:Middle Aged; D011183:Postoperative Complications; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome