title: A comparison between metatarsal head-resurfacing hemiarthroplasty and total metatarsophalangeal joint arthroplasty as surgical treatments for hallux rigidus: a retrospective study with short- to midterm follow-up.
abstract: OBJECTIVE
  We evaluated the short- to midterm outcomes of metatarsal head-resurfacing hemiarthroplasty and total metatarsophalangeal joint arthroplasty (total joint replacement [TJR]) as surgical treatments for advanced-stage hallux rigidus (HR).
  
  
  METHODS
  From 2012 to 2014, all data from patients who underwent surgery for the treatment of grades 2-3 HR were retrospectively reviewed, and 45 patients were included in this study. Of these patients, 26 underwent metatarsal head-resurfacing hemiarthroplasty (Group I) and 19 underwent TJR (Group II). All patients were clinically graded prior to surgery and at their final follow-up visits using the American Orthopedic Foot and Ankle Society's (AOFAS) hallux metatarsophalangeal-interphalangeal scale, a visual analog scale (VAS), and the "first metatarsophalangeal joint range of motion" (MTPJ ROM) score.
  
  
  RESULTS
  Metatarsal head resurfacing was performed on 26 patients. Two patients underwent bilateral procedures, yielding a total of 28 cases in Group I. TJR was performed on 19 patients in Group II. Of the 26 Group I patients, 12 (46.2%) were male and 14 (53.8%) were female, with a mean age of 56.3±4.5 years (range: 47-63 years); the mean follow-up duration was 29.9±5.2 months. Of the 19 Group II patients, eight (42.1%) were male and eleven (57.9%) were female, with a mean age of 57.1±5.8 years (range: 45-66 years); the mean follow-up duration was 27.1±7.5 months. Significant improvements were evident in the AOFAS scores, and the VAS scores decreased, in both groups. No significant difference was evident between groups I and II.
  
  
  CONCLUSIONS
  After failure of conservative treatment in patients with moderate-to-severe HR, both MTPJ hemiarthroplasty and TJR were associated with effective recovery of toe function and MTPJ ROM, as well as good short- to midterm functional outcomes.
authors.affiliation: Department of Orthopaedics and Traumatology, Medical School, Bozok University.
authors.forename: Musa Ugur
authors.initials: MU
authors.lastname: Mermerkaya
authors.affiliation: Department of Orthopaedics and Traumatology, Yozgat State Hospital, Yozgat, Turkey.
authors.forename: Houman
authors.initials: H
authors.lastname: Adli
mesh_terms: D000368:Aged; D019643:Arthroplasty, Replacement / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D020859:Hallux Rigidus / Q000601:surgery*; D062785:Hemiarthroplasty / Q000379:methods*; D006801:Humans; D008297:Male; D008682:Metatarsal Bones / Q000601:surgery*; D008683:Metatarsophalangeal Joint / Q000601:surgery*; D008875:Middle Aged; D010147:Pain Measurement; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D012720:Severity of Illness Index; D064232:Visual Analog Scale
keywords: HemiCAP®; ToeFit-Plus®; arthroplasty; hallux rigidus; surgical treatment