Arthrodesis of the First Metatarsophalangeal Joint for Idiopathic Hallux Valgus: Intermediate Results

Abstract

In the present study, arthrodesis of the first MTP joint for idiopathic hallux valgus resulted in a high percentage of successful results at an average followup of over 8 years.

Pseudoarthrosis repair after failed metatarsophalangeal 1 arthrodesis

“…Pseudoarthrosis after attempted MTP-1 arthrodesis occurs in 1–14% of cases (Coughlin and Shurnas 2003, Coughlin et al 2005, Gaucher and Coughlin 2006, Bennet and Sabatta 2009). Hope et al (2010) described acceptable outcome scores with only removal of material and debridement in 7 of 11 patients.…”

The Modified Oblique Keller Capsular Interpositional Arthroplasty for Hallux Rigidus

“…Residual pain at the first metatarsophalangeal joint after arthrodesis was rated at 0.4 on a 10-point visual analog scale. A recent report on arthrodesis for the treatment of hallux valgus deformity demonstrated a 33% rate of progression of interphalangeal joint arthritis after an average duration of follow-up of 8.6 years, although not all patients were symptomatic 1 . Despite the success of arthrodesis in terms of reducing pain and providing excellent functional improvements, some patients object to the joint stiffness and the real or perceived functional limitations incurred in association with arthrodesis.…”

“…Each option offers specific advantages and disadvantages. Arthrodesis is associated with malunion, nonunion, shortening, and transfer metatarsalgia 1 . It eliminates motion and pain in most patients, but the concept of eliminating motion at the first metatarsophalangeal joint is not easily accepted by many patients.…”

Early results of an intraosseous device for arthrodesis of the hallux metatarsophalangeal joint

“…Arthrodesis of the hallux metatarsophalangeal (MTP) joint is commonly used as a primary procedure either to correct severe hallux valgus deformities or for rheumatoid arthritis, hallux rigidus, in patients with neuromuscular disorders and as a salvage procedure for failed bunion surgery or infection 12345. The rationale is to preserve the length of the first metatarsal and provide stability of the first ray so that weight can be transferred to the hallux.…”