Ultrasound-guided arthroscopic management of hallux rigidus.
BACKGROUND
The use of metatarso-phalangeal joint arthroscopy in the treatment of osteochondritis dissecans was first described in 1988. The technique produces good results. However, it can be difficult to enter a joint when it is deformed by degenerative disease. Sonography is a modern visualisation modality which can be used in orthopaedic surgery.


OBJECTIVE
To describe a method of intraoperative sonographic navigation during first metatarso-phalangeal joint arthroscopy.


METHODS
The modality was used in 3 patients. The joint was visualised in the ultrasound scanner. After confirming the intra-articular position of the guide needle, a medial portal was established. The procedure started with the removal and vaporisation of the hypertrophic synovium. Gradual resection of the osteophytes was then carried out. The procedure was terminated after the ultrasound image showed that a smooth upper surface of the metatarsal head had been achieved.


RESULTS
All 3 patients were satisfied with the procedure and function of the treated feet. Average surgery time was 81 min. No complications were found.


CONCLUSIONS
Mini-invasive treatment of hallux rigidus with sonography-guided arthroscopic cheilectomy appears to be a reproducible procedure leading to good clinical results. We encourage surgeons familiar with ultrasound visualisation of the joints to use the technique described in this paper in the arthroscopic treatment of hallux rigidus.
Orvit Clinic, Citomed Health Centre, Torun, Poland.
Łukasz M
ŁM
Paczesny
Department of Orthopaedics, Orthopaedic Oncology and Traumatology, Poznan University of Medical Science, Poznan, Poland.
Jacek
J
Kruczyński
arthroscopy; hallux rigidus; ultrasonography; ultrasound-guided