title: Outcomes After Interpositional Arthroplasty of the First Metatarsophalangeal Joint.
abstract: BACKGROUND
  For patients with hallux rigidus seeking a motion-sparing procedure, interposition arthroplasty is an alternative to fusion. The purpose of this study was to report patient outcomes after interpositional arthroplasty for hallux rigidus.
  
  
  METHODS
  All patients undergoing interpositional arthroplasty at our institution from 2001 to 2014 were identified and a retrospective chart review was performed. Follow-up was conducted through a telephone survey to obtain survivorship, satisfaction, and functional scores. Survivorship of the interpositional arthroplasty procedure was defined as no subsequent surgery on the hallux after the index procedure. Patients were excluded for incomplete records. Complications were recorded. From 2001 to 2014, 183 patients were identified. Of these, 14 were excluded for incomplete data, leaving 169 patients. Of these, 133 had an average follow-up of 62.2 months (range, 24.3 months to 151.2 months).
  
  
  RESULTS
  The overall failure rate was 3.8% (5/133). Patient-reported outcome was rated as excellent in 65.4% (87/133) or good in 24.1% (32/133) of patients and fair or poor in 10.5% (14/133) of patients. Of 133 patients, 101 (76%) were able to return to fashionable or regular footwear. The infection rate was 1.5% (2/133). Patient-reported cock-up deformity of the first metatarsophalangeal joint (MTPJ) occurred in 4.5% (6/133) of patients. In addition, 17.3% (23/133) of patients reported metatarsalgia of the second or third MTPJ at the time of final follow-up, and there was no significant difference between interposition types ( P = .441).
  
  
  CONCLUSIONS
  Interpositional arthroplasty for hallux rigidus was found to have excellent or good results in most patients at a mean follow-up of 62.2 months.
  
  
  METHODS
  Level IV, retrospective case series.
authors.affiliation: 1 Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA.
authors.forename: Michael C
authors.initials: MC
authors.lastname: Aynardi
authors.affiliation: 1 Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA.
authors.forename: Lara
authors.initials: L
authors.lastname: Atwater
authors.affiliation: 1 Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Dein
authors.affiliation: 1 Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA.
authors.forename: Talal
authors.initials: T
authors.lastname: Zahoor
authors.affiliation: 1 Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA.
authors.forename: Lew C
authors.initials: LC
authors.lastname: Schon
authors.affiliation: 1 Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA.
authors.forename: Stuart D
authors.initials: SD
authors.lastname: Miller
mesh_terms: D001178:Arthroplasty / Q000379:methods; D006214:Hallux / Q000601:surgery*; D006801:Humans; D037061:Metatarsalgia / Q000601:surgery*; D008683:Metatarsophalangeal Joint / Q000503:physiopathology / Q000601:surgery*; D016059:Range of Motion, Articular / Q000502:physiology*; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: hallux rigidus; interposition arthroplasty; outcomes; survivorship