Long-Term Follow-Up of the Cheilectomy for Degenerative Joint Disease of the First Metatarsophalangeal Joint

Nicolosi, Nicole; Hehemann, Chris; Connors, James C.; Boike, Allan

doi:10.1053/j.jfas.2014.12.035

Cited by 24 publications

(12 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…4 Easley et al 6 reported in their series that 90% of the patients were satisfied with increased range, and there was a 40-point improvement in American Orthopaedic Foot & Ankle Society (AOFAS) score following cheilectomy at mean follow-up of 63 months. Of the 58 patients in the series of Nicolosi et al, 12 51 (87.9%) experienced no limitations in their daily activities at an average follow-up of 7.1 years, with 2 patients (3.3%) subsequently requiring an arthrodesis. Roukis 14 performed a systematic review of isolated cheilectomy of the first MTP joint and concluded that the overall rate for revision surgery was 8.8%.…”

Section: Discussionmentioning

confidence: 90%

See 1 more Smart Citation

Clinical Outcomes Following Minimally Invasive Dorsal Cheilectomy for Hallux Rigidus

et al. 2018

View full text Add to dashboard Cite

Background: Following failure of conservative treatment, a dorsal cheilectomy can be performed for patients in early stages of hallux rigidus by a traditional open approach or by a minimally invasive technique. We report our clinical outcomes following minimally invasive dorsal cheilectomy (MIDC). Methods: Eighty-nine patients (98 feet) with symptomatic hallux rigidus treated between 2011 and 2016 were included in this study. The average age was 54 years. Manchester-Oxford Foot Questionnaire (MOxFQ) scores and visual analog scale (VAS) pain scores were collected. The mean follow-up was 50 months. Results: The average VAS score improved from 8.0 preoperatively to 3 postoperatively. The mean MOxFQ summary index score decreased from 58.6 preoperatively to 30.5 postoperatively. All 3 MOxFQ domains also improved. Swelling took an average of 5.3 weeks to settle. There were 2 wound infections and 2 delayed wound healings. Two patients had transient nerve paraesthesia, while 2 patients had permanent numbness in the dorsomedial cutaneous nerve distribution. Twelve patients (12%) underwent reoperation, of which 7 had a first metatarsophalangeal joint arthrodesis for ongoing pain, 4 had repeat cheilectomy for residual impingement, and 1 had an open removal of loose bone. Conclusion: Our results suggest that MIDC resulted in improvement in patient-reported outcome measures and was a safe technique with minimal complications. The complications were similar to open cheilectomy. There was an associated learning curve as 5 of our reoperations were due to incomplete cheilectomy. Coughlin grade 1 did well with MIDC as with open cheilectomy as none went onto an arthrodesis. However, 10% (7/65) of our grade 2 and 3 cases went on to an arthrodesis. Level of Evidence: Level IV, retrospective case series.

show abstract

Section: Discussionmentioning

confidence: 90%

“…Our results were similar to published series of open cheilectomy, and MIDC seems to be a safe alternative to open surgery. 4,6,9,12 The aim of our study was not to prove whether MIDC was superior, inferior, or equivocal to open cheilectomy. Only a well-designed, large randomized controlled trial could conclusively show this.…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcomes Following Minimally Invasive Dorsal Cheilectomy for Hallux Rigidus

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Similarly, Bussewitz et al[18] reported an overall success rate of 98.5% in 197 cases with a mean follow-up of 3.2 years. Nicolosi et al[20] evaluated the long-term efficacy of aggressive cheilectomy by analyzing patient satisfaction using American Orthopaedic Foot and Ankle Society (AOFAS) scale in 58 patients with mean follow-up period of 7 years. The average improvement in pain relief was 87.71%, and 94.83% of all patients stated that they would undergo the same procedure again.…”

Section: Cheilectomymentioning

confidence: 99%

Hallux rigidus: How do I approach it?

Lam¹,

Chan²,

Surace³

et al. 2017

WJO

View full text Add to dashboard Cite

Hallux rigidus is a degenerative disease of the first metatarsalphalangeal (MTP) joint and affects 2.5% of people over age 50. Dorsal osteophytes and narrowed joint space leads to debilitating pain and limited range of motion. Altered gait mechanics often ensued as 119% of the body force transmit through the 1st MTP joint during gait cycle. Precise etiology remains under debate with trauma being often cited in the literature. Hallux valgus interphalangeus, female gender, inflammatory and metabolic conditions have all been identified as associative factors. Clinical symptoms, physical exam and radiographic evidence are important in assessing and grading the disease. Non-operative managements including nonsteroidal antiinflammatory drugs, intra-articular injections, shoe modification, activity modification and physical therapy, should always be attempted for all hallux rigidus patients. The goal of surgery is to relieve pain, maintain stability of the first MTP joint, and improve function and quality of life. Operative treatments can be divided into joint-sparing vs joint-sacrificing. Cheilectomy and moberg osteotomy are examples of joint-sparing techniques that have demonstrated great success in early stages of hallux rigidus. Arthrodesis is a joint-sacrificing procedure that has been the gold standard for advanced hallux rigidus. Other newer procedures such as implant arthroplasty, interpositional arthroplasty and arthroscopy, have demonstrated promising early patient outcomes. However, future studies are still needed to validate its long-term efficacy and safety. The choice of procedure should be based on the condition of the joint, patient’s goal and expectations, and surgeon’s experience with the technique.

show abstract

“…The results of this study concur with those of several studies in the literature that document from 0% to 8.8% of cases of open cheilectomy requiring 1MTPJ arthrodesis. 7,13,17,19 In comparison, 12.8% (17/133) of the MIS cheilectomy group needed further surgery. The second surgery was for intrinsic 1MTPJ pain and stiffness in 7.5% (10/133) of cases, with 9 proceeding to 1MTPJ arthrodesis and 1 case proceeding to interposition arthroplasty with a hydrogel implant.…”

Section: Discussionmentioning

confidence: 97%

“…6 Studies have repeatedly demonstrated good efficacy and few complications for cheilectomy. 3,10,17,20 The advantages of an open approach are that it allows direct visualization of the joint surfaces, can address chondral defects, and allows for an extensive soft tissue release. The perceived disadvantages are a larger soft tissue insult and the need to protect the wound from early mobilization until it is healed.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Complication and Reoperation Rates for Minimally Invasive Versus Open Cheilectomy of the First Metatarsophalangeal Joint

et al. 2019

View full text Add to dashboard Cite

Background: Dorsal cheilectomy of the first metatarsophalangeal joint is an accepted treatment to alleviate dorsal impingement, pain, and reduced dorsiflexion in hallux rigidus. Traditionally performed via an open incision, this procedure has more recently been performed using minimally invasive techniques despite limited supportive published evidence. Methods: From December 2012 through December 2017, a retrospective analysis of all cheilectomies performed in our institution was done. The surgical technique was recorded along with any subsequent procedures performed for either persistent or recurrent pain, and complications were also noted. A comparison between open and minimally invasive outcomes was performed. In total, 171 cheilectomies were performed during this period. There were 38 open and 133 minimally invasive procedures. Results: At a mean 3-year follow-up, the reoperation rates of the 2 groups were different with only 1 (2.6%) of the open group requiring a fusion, while 17 (12.8%) of the minimally invasive surgical (MIS) group required further surgery (relative risk, 4.86; P = .059). In the open group, there was 1 (2.6%) complication, compared with 15 (11.3%) in the minimally invasive group (relative risk, 4.29; P = .076). Conclusion: While patients may opt for MIS cheilectomy with a proposed faster recovery time and better cosmesis, they should be counseled about the risks and benefits of both methods, and that the technique of MIS cheilectomy utilized in this study appears to have an increased relative risk of requiring a further procedure. Level of Evidence: Level III, retrospective comparative series.

show abstract

Long-Term Follow-Up of the Cheilectomy for Degenerative Joint Disease of the First Metatarsophalangeal Joint

Cited by 24 publications

References 24 publications

Clinical Outcomes Following Minimally Invasive Dorsal Cheilectomy for Hallux Rigidus

Clinical Outcomes Following Minimally Invasive Dorsal Cheilectomy for Hallux Rigidus

Hallux rigidus: How do I approach it?

Comparison of Complication and Reoperation Rates for Minimally Invasive Versus Open Cheilectomy of the First Metatarsophalangeal Joint

Contact Info

Product

Resources

About