title: Metatarsal head resurfacing arthroplasty in the treatment of hallux rigidus: is it reliable treatment option?
abstract: BACKGROUND
  This study looks at the failure and complications arising secondary to resurfacing and hemi-arthroplasty done at the metatarsal head in patients with hallux rigidus. Our report includes a review of the relevant literature to verify the validity of our techniques.
  
  
  METHODS
  We performed metatarsal head resurfacing with hemi-arthroplasty using the HemiCap(®), on 12 patients with hallux rigidus between the dates of March 2010 and October 2013. The mean follow-up period was 22.3 months (range 12-54). All patients were clinically and radiologically evaluated according to the American Orthopedics Foot and Ankle Society (AOFAS) functional scale and the Coughlin and Shurnas classification.
  
  
  RESULTS
  The recorded mean AOFAS score showed an increase from the preoperative score of 49.2 ± 13.1 to a postoperative follow-up score of 80.8 ± 13.1 (p < 0.001). Pain scores also showed an improvement from 16.5 ± 7.1 points preoperatively to 32.5 ± 6.9 points during the postoperative follow-up (p < 0.001). The mean function score improved from 17.7 ± 7.6 points preoperatively to 33.2 ± 7.6 points during the final postoperative follow-up (p < 0.001). Furthermore, the mean range of motion improved from 16.3 ± 4.8° preoperatively to 45.4 ± 13.2° postoperatively (p < 0.001). Three patients (25 %) reported pain at rest. Surgical revision was done on these patients who have significant pain that limited their range of motion.
  
  
  CONCLUSIONS
  Favorable outcomes were achieved by performing minimal bone resection which also helps maintain metatarso-phalangeal joint function through metatarsal head resurfacing arthroplasty. We expect the failure rates to decrease with the advancements of surgical techniques. Selecting the appropriate patient populous in the application of the technique is crucial in attaining successful clinical results.
authors.affiliation: Department of Orthopedics and Traumatology, Istanbul Education and Research Hospital, Istanbul, Turkey. esracirci@hotmail.com.
authors.forename: E
authors.initials: E
authors.lastname: Circi
authors.affiliation: Department of Orthopedics and Traumatology, Istanbul Education and Research Hospital, Istanbul, Turkey.
authors.forename: T
authors.initials: T
authors.lastname: Tuzuner
authors.affiliation: Department of Orthopedics and Traumatology, Istanbul Education and Research Hospital, Istanbul, Turkey.
authors.forename: E
authors.initials: E
authors.lastname: Sukur
authors.affiliation: Department of Orthopedics and Traumatology, Istanbul Education and Research Hospital, Istanbul, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Baris
authors.affiliation: Department of Orthopedics and Traumatology, Istanbul Education and Research Hospital, Istanbul, Turkey.
authors.forename: E
authors.initials: E
authors.lastname: Kanay
mesh_terms: D000368:Aged; D001178:Arthroplasty / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D020859:Hallux Rigidus / Q000601:surgery*; D006801:Humans; D008297:Male; D008682:Metatarsal Bones / Q000601:surgery*; D008683:Metatarsophalangeal Joint / Q000601:surgery*; D008875:Middle Aged; D019736:Prostheses and Implants; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: Failure; Hallux rigidus; Metatarsal head resurfacing hemi-arthroplasty