title: Autogenous capsular interpositional arthroplasty surgery for painful hallux rigidus: assessing changes in range of motion and postoperative foot health.
abstract: The autogenous capsular interpositional arthroplasty procedure can be a motion-sparing alternative to arthrodesis for the treatment of recalcitrant hallux rigidus deformity. Previous studies have reported positive results; however, many had small samples or lacked comparable preoperative measures. The present study used a prospective cohort study to assess the benefit of this technique for increasing range of motion, and comparative data to assess the reduction of pain and improvements in perceived foot health status for a consecutively drawn sample of patients. Thirty-four patients (44 feet) reviewed using a long-arm goniometer at a mean of 3.75 years after surgery experienced a significant increase in dorsiflexion (preoperative mean 11.09° ± 10.13°; postoperative mean 26.64° ± 10.07°; p < .001); plantar flexion remained unchanged. Additionally, 15 of 17 patients for whom the hallux abductus angle was initially greater than the normal range was within the normal range postoperatively. The postoperative patient perceptions of foot pain were significantly better than those from a comparable sample of patients presenting for a surgical opinion (t[69] = 6.80), just as were the perceptions of foot function, foot health, and footwear comfort (p < .001 for all). The postoperative perceptions of foot pain were comparable with the postoperative results from a range of previously published studies. These results have shown, with improvements in range of motion and reduction in pain, that autogenous capsular interpositional arthroplasty is a useful, motion-sparing technique in the treatment of painful hallux rigidus and should be considered for classification as a clinical practice guideline.
authors.affiliation: Surgeon, ACT Podiatry, Australasian College of Podiatric Surgeons, Victoria, Australia. Electronic address: admin@actpodiatry.com.au.
authors.forename: Clayton N L
authors.initials: CN
authors.lastname: Clews
authors.affiliation: Surgeon, Kingsford Podiatry Group, Australasian College of Podiatric Surgeons Victoria, Australia.
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Kingsford
authors.affiliation: Registrar, Kingsford Podiatry Group, Australasian College of Podiatric Surgeons, Victoria, Australia.
authors.forename: Dean J
authors.initials: DJ
authors.lastname: Samaras
mesh_terms: D018771:Arthralgia / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D053587:Arthrometry, Articular; D001178:Arthroplasty / Q000379:methods*; D020859:Hallux Rigidus / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D006304:Health Status; D006801:Humans; D017746:Joint Capsule / Q000637:transplantation*; D011446:Prospective Studies; D016059:Range of Motion, Articular; D014182:Transplantation, Autologous
keywords: autogenous capsular interpositional arthroplasty; first metatarsophalangeal joint; foot health status questionnaire; hallux rigidus; range of motion