Improved ankle push-off power following cheilectomy for hallux rigidus: a prospective gait analysis study.
BACKGROUND
There is limited objective scientific information on the functional effects of cheilectomy. The purpose of this study was to test the hypothesis that cheilectomy for hallux rigidus improves gait by increasing ankle push-off power.


METHODS
Seventeen patients with symptomatic Stage 1 or Stage 2 hallux rigidus were studied. Pre- and postoperative first metatarsophalangeal (MTP) range of motion and AOFAS hallux scores were recorded. A gait analysis was performed within 4 weeks prior to surgery and repeated at a minimum of 1 year after surgery. Gait analysis was done using a three-dimensional motion capture system and a force platform embedded in a 10-m walkway. Gait velocity sagittal plane ankle range of motion and peak sagittal plane ankle push-off power were analyzed.


RESULTS
Following cheilectomy, significant increases were noted for first MTP range of motion and AOFAS hallux score. First MTP motion improved an average of 16.7 degrees, from means of 33.9 degrees preoperatively to 50.6 degrees postoperatively (p<0.001). AOFAS hallux score increased from 62 to 81 (p<0.007). As demonstrated through gait anaylsis, a significant increase in postoperative peak sagittal plane ankle push-off power from 1.71±0.92 W/kg to 2.05±0.75 W/kg (p<0.04).


CONCLUSIONS
In addition to clinically increased range of motion and improved AOFAS Hallux score, first MTP joint cheilectomy produced objective improvement in gait, as measured by increased peak sagittal-plane ankle push-off power.
Baylor University Medical Center, Department of Orthopaedic Surgery, Dallas, TX 75246, USA.
Sheryl M
SM
Smith
Scott C
SC
Coleman
Stacy A
SA
Bacon
Fabian E
FE
Polo
James W
JW
Brodsky
D000328:Adult; D000843:Ankle Joint / Q000502:physiology*; D005260:Female; D005684:Gait / Q000502:physiology*; D020859:Hallux Rigidus / Q000145:classification / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008682:Metatarsal Bones / Q000601:surgery; D008683:Metatarsophalangeal Joint / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D019637:Orthopedic Procedures; D054850:Osteophyte / Q000601:surgery*; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology