Hemiarthroplasty in the Treatment of Hallux Rigidus

Sorbie, Charles; Saunders, G.

doi:10.3113/fai.2008.0273

Cited by 53 publications

(35 citation statements)

References 43 publications

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“…They showed good results with two implant revisions, but overall there seems to be no significant difference with metatarsal implants. Sorbie and Saunders [22], in a prospective study on 23 patients, used a cemented phalangeal hemiarthroplasty and reported an improvement of the motion from 57 points (range 39-80) on the preoperative AOFAS to 88 points (range 75-100) at a follow-up of 34-72 months. No complications were reported by the authors, with the exception of a small hematoma; only one patient, 3 years after the treatment, required a new surgical approach to repair the pre-existing hallux valgus.…”

Section: Discussionmentioning

confidence: 98%

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

Cannavò

Costarella

Pavone

et al. 2016

JFMK

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Abstract:Hallux rigidus (HR) is a progressive degenerative pathology affecting the first metatarsophalangeal joint. The aim of the present study is to report our experience on the treatment of HR patients with two different surgical methods: arthrodesis and hemiarthroplasty. Twelve patients (14 HR) underwent surgery for HR from July 2004 to October 2009. Median age was 58 years (Interquartile Range (IQR) 52.75-65.0). At time of surgery, patients had different grades of HR, according to the Regnauld modified classification. The outcome was assessed using the American Orthopedic Foot and Ankle Society (AOFAS) Hallux Metatarsophalangeal-Interphalangeal (HMI) scale. Controls were performed at one month and then at mid-term follow-up (median 48 months; IQR 29.3-58.0). In the arthrodesis group (n = 6 HR) we observed a median improvement of 35.5 points (IQR 34.75-36.0; p = 0.036) at the early follow-up. In the hemiarthroplasty (n = 8 HR) group the median of differences at the one-month follow-up was 33 (IQR 30.5-33.0; p = 0.022). At mid-term follow-up the arthrodesis group showed the median difference score of 35 in comparison with the hemiarthroplasty group which showed a median score of 30.5 (IQR 28.0-32.5). Our results are consistent with the current understanding of two surgical techniques for the treatment of HR: nowadays, arthrodesis is considered the treatment of choice in grade III and IV. Hemiarthroplasty seems to be a promising option. Management of pain and joint flexibility are fundamental to prevent relapses and restore the Range Of Motion (ROM) in dorsal flexion. This article is a retrospective case series with a level of evidence 4.

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Section: Discussionmentioning

confidence: 98%

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

Cannavò

Costarella

Pavone

et al. 2016

JFMK

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“…The primary patient expectations are usually pain relief and functional improvement. Oral nonsteroidal anti-inflammatory drugs, activity restrictions, footwear modifications, and intra-articular steroid injections are the principal conservative treatment options for early management of HR 20. However, management of advanced (stages II and III) HR remains controversial; many authors have described various methods, including interposition arthroplasty, resection arthroplasty, partial or total MTPJ arthroplasty, and joint fusion 8–18.…”

Section: Discussionmentioning

confidence: 99%

“…HR can be either idiopathic or traumatic (micro- or macrotrauma to the cartilage of the first MTPJ can damage, and trigger erosion of, joint surfaces) and is associated with the production of dorsal osteophytes 2–7. Several conservative and surgical treatment options have been reported in the literature; age, activity level, patient expectations, and the severity of arthrosis must be considered when choosing the best treatment option 2–20. However, the management of advanced HR (stages II and III) remains controversial; many authors have reported a variety of techniques, including interposition arthroplasty, resection arthroplasty, partial or total MTPJ arthroplasty, and joint fusion 8,10–18.…”

Section: Introductionmentioning

confidence: 99%

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

Mermerkaya

Adli²

2016

CIA

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PurposeWe 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).Patients and methodsFrom 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.ResultsMetatarsal 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.ConclusionAfter 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.

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“…Sorbie e Saunders 10 designed a prospective study with use of cemented hemiarthroplasty and observed improvement in the AOFAS score from 57 to 88 points, with follow-up ranging from 34-72 months, concluding that hemiarthroplasty improves pain symptoms, joint motion, bending force and joint alignment. The authors found no signs of osteolysis or loosening of the prosthesis.…”

Section: Discussionmentioning

confidence: 99%

“…It represents the most common form of osteoarthrosis of the foot and ankle, with annual prevalence of 2-10%, 1 , 2 predominance in females in the ratio, 1:1.6 3 - 10 and peak of incidence in the population after 50 years old 11 …”

Section: Introductionmentioning

confidence: 99%

Hállux Rígidus: estudo prospectivo da substituição articular com hemiartroplastia

et al. 2013

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OBJECTIVE: To report the results of medium-term follow-up after deploying Arthrosurface-HemiCap(r) in patients with diagnosis of Hállux Rigidus (HR). METHOD: Eleven patients underwent partial Arthroplasty of the first metatarsal-phalangeal joint. Six women and five men with an average age 51.9 years (46 to 58 years) and average postoperative follow-up of 3.73 years (3-4 years); were classified through the Kravitz system and evaluated by the American Orthopaedic Foot and Ankle Society (AOFAS) scales for hállux, Visual Analogical Scale (VAS) - analog functional pain - and range of motion in the first metatarsal joint in preoperative, postoperative after six months and present post-operative. RESULTS: The results show significant improvement of the three analyzed parameters, both for overall analysis and for pre and post-operative comparisons individually. The comparative analysis of each variable in the six months and the current postoperative periods do not show statistically significant differences, indicating maintenance of parameters during this interval. CONCLUSION: hemiarthroplasty of first metatarsophalangeal joint is a reproducible and safe option for the surgical treatment of hállux rigidus II and III, with significant improvement of the evaluated parameters for the studied population. Level of Evidence IV, Case Series.

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Hemiarthroplasty in the Treatment of Hallux Rigidus

Abstract: A hemiarthroplasty retained, in most cases, joint mobility, strength, and alignment while relieving pain. There was no evidence, at last followup, of component loosening or osteolysis.

Cited by 53 publications

References 43 publications

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

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

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

Hállux Rígidus: estudo prospectivo da substituição articular com hemiartroplastia

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