First metatarsophalangeal hemiarthroplasty for hallux rigidus

Abstract

There is a paucity of objective information in the literature about first metatarsophalangeal (MTP) hemiarthroplasty. The authors postulate that it is a reasonable treatment option for severe hallux rigidus in selected patients. Twenty-two elective first MTP hemiarthroplasties were performed on 20 patients that met the inclusion criteria. Pre- and postoperative evaluations were done using the American Orthopaedic Foot and Ankle Society (AOFAS) forefoot score, visual analogue scale (VAS) pain score, range of motion (ROM) measurements, and radiographs. Average ROM and dorsiflexion improved by 15° and 8°, respectively. VAS pain scores improved from 5 to 2.5 after six weeks. Painless ambulation occurred after six weeks, with maximum improvement by six months. After 24 months, two patients had pain at the surgical site interfering with function, leading to an unsatisfactory result that required conversion to arthrodesis. First MTP hemiarthroplasty for severe hallux rigidus can be considered an alternative to fusion in properly selected patients who wish to maintain a functional range of motion.

Short-Term Clinical Outcome of Hemiarthroplasty Versus Arthrodesis for End-Stage Hallux Rigidus

“…However, hemiarthroplasty survival is uncertain, and complications such as loosening of the implant, infections, arthrofibrosis, mechanical deformity, and persistent pain have been reported (3,5,6). Published studies have reported ambivalent results for first MTPJ hemiarthroplasty, with a limited number of studies reporting satisfying results (5)(6)(7)(8). In contrast, arthrodesis is more predictable in its outcome.…”

Hemiarthroplasty for Hallux Rigidus: Mid-Term Results

“…If the operation is successful, it will theoretically maintain the range of movement within the joint, an important advantage for hemiarthroplasty. Replacement of only 1 surface ensures the maintenance of toe length and generally requires minimal bone resection, allowing easy conversion to arthrodesis, if necessary (6).…”

“…MTPJ hemiarthroplasty was introduced in 1952; however, since then, few studies have documented the mid-and long-term outcomes of patients undergoing this procedure (6,9). Thus, the aim of the present study was to determine whether first MTPJ hemiarthroplasty with the HemiCAP Ò prosthesis (Arthrosurface Ò , Franklin, MA) provides satisfactory outcomes in the treatment of hallux rigidus.…”

Arthrodesis and Hemiarthroplasty: Different Techniques in the Treatment of Hallux Rigidus—Surgery and Postoperative Rehabilitation

“…An article by Hopson et al [21] describes the failure of one of these implants due to mobilization. Looking at the phalangeal implants, Giza et al [18] published the results of a series of 22 feet treated with phalangeal hemiarthroplasty. They showed good results with two implant revisions, but overall there seems to be no significant difference with metatarsal implants.…”

“…The aim of the present study is to compare the pros and cons of two different surgical methods widely reported in literature: arthrodesis and hemiarthroplasty [13][14][15][16][17][18].…”