title: A Prospective Comparison of Clinical, Radiographic, and Intraoperative Features of Hallux Rigidus: Long-Term Follow-Up and Analysis.
abstract: Forty-seven patients (50 feet) underwent surgical intervention for symptomatic hallux rigidus from February 1998 to April 1999. Thirty-eight patients (41 feet) returned at 1 year for a follow-up evaluation. Of these 38 patients, 20 (21 feet) returned for the 15-year follow-up evaluation. Subjective evaluations were performed using the modified American Orthopaedic Foot and Ankle Surgery hallux metatarsophalangeal-interphalangeal 100-point scale. Long-term postoperative objective physical examination and radiographic analysis were performed. These data were compared with the preoperative and short-term follow-up data. The subjective evaluation showed a statistically significant differing over the long term, with a mean increase of 27.6 points. The results of the physical examination and radiographic measurements were mixed. The long-term dorsal range of motion was not significant across surgery type. Radiographically, the procedure types resulted in similar changes, suggesting that neither joint preservation nor joint destructive procedures were more stable over time. Plantar transposition of the capital fragment, offsetting the longitudinal shortening of the first metatarsal, was not significant, confirming the short-term findings. For this patient population, the long-term results of surgical intervention for hallux rigidus, regardless of procedure type, provided subjective patient improvement but no statistically significant increase in first metatarsophalangeal joint function or dorsal range of motion.
authors.affiliation: Gundersen Lutheran Medical Foundation, La Crosse, WI.
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Elliott
authors.affiliation: Department of Medical Research, Gundersen Health System, La Crosse, WI.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Borgert
authors.affiliation: Orthopaedic Center, Gundersen Health System, La Crosse, WI. Electronic address: tsroukis@gundersenhealth.org.
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Roukis
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D020859:Hallux Rigidus / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D010027:Osteotomy / Q000009:adverse effects / Q000379:methods*; D010147:Pain Measurement; D011446:Prospective Studies; D011859:Radiography / Q000379:methods; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function; D018570:Risk Assessment; D013995:Time; D016896:Treatment Outcome
keywords: Decompression osteotomy; First metatarsophalangeal joint; Hallux rigidus; Implant arthroplasty; Long-term follow-up