Surgical options for hallux rigidus: state of the art and review of the literature

Galois, Laurent; Hemmer, Julien; Ray, V.; Sirveaux, François

doi:10.1007/s00590-019-02528-x

Cited by 59 publications

(46 citation statements)

References 49 publications

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“…Hallux rigidus (HR), which affects approximately 2% of the population, can be graded based on the severity of the disease (Lucas et al 2015, Lam et al 2017, Galois et al 2020. Beeson et al (2008) conducted a literature review of the existing multiple classification systems where the system promoted by Coughlin and Shurnas (2003) was deemed to have the most reliable grading.…”

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confidence: 99%

“…Several studies have shown positive outcomes for different surgical procedures (Coughlin and Shurnas 2003, Stevens et al 2017, Coutts and Kilmartin 2019, Sidon et al 2019, Slullitel et al 2019, but there is a lack of consensus on what procedure should be chosen for a certain grade of HR (Galois et al 2020). For moderate HR, when joint-preserving surgery is preferred, techniques such as cheilectomy, phalangeal and metatarsal osteotomies could be used (Coughlin and Shurnas 2003, Slullitel et al 2016, Sidon et al 2019, Galois et al 2020. The evidence regarding which of these techniques should be used is, however, sparse.…”

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confidence: 99%

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Patient-reported outcomes of joint-preserving surgery for moderate hallux rigidus: a 1-year follow-up of 296 patients from Swefoot

2020

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Background and purpose — Hallux rigidus (HR) may cause decreased range of motion, joint pain, and gait disturbances. There is a lack of evidence regarding the outcome of different surgical procedures for moderate HR. We report patient-reported outcomes after joint-preserving surgical procedures for moderate HR. Patients and methods — We included 296 patients registered in Swefoot (Swedish national registry of foot and ankle surgery) who underwent primary surgery for moderate HR 2014 through 2018. We extracted information on anthropometrics, grading of HR, chosen surgical procedure, and patient-reported data including the PROMs SEFAS (summary score 0–48) and EQ-5D-3L (index 0–1) preoperatively and 1 year postoperatively. Results — 115 patients underwent metatarsal decompression (i.e., Youngswick) osteotomy (YOT) and 181 underwent cheilectomy. The mean improvement in SEFAS score 1 year after surgery was 12 points (95% CI 10 − 13) for YOT and 10 points (CI 9 − 12) for cheilectomy. Also, EQ-5D improved in both groups. Patients who underwent YOT were more satisfied with the procedure (84% vs. 70% for cheilectomy, p = 0.02). Interpretation — Surgically treated patients with moderate HR improved after both YOT and cheilectomy, according to patient-reported data from Swefoot. Patients who underwent a YOT were more satisfied with their procedure. One possible explanation may be that more patients in the YOT group had a concomitant hallux valgus; however, we have no information on this.

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Patient-reported outcomes of joint-preserving surgery for moderate hallux rigidus: a 1-year follow-up of 296 patients from Swefoot

2020

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“…Hallux rigidus is degenerative arthritis of the first metatarsophalangeal joint characterized by a painful limitation of motion at the joint. 9,24 It is the most common degenerative joint disease of the foot and the most common illness of the great toe after hallux valgus. 8 The typical patient often presents with pain, swelling, and stiffness at the joint.…”

Section: Introductionmentioning

confidence: 99%

“…2 The suggested risk factors of the disease are the excessive length of the first ray, trauma, abnormally elevated first metatarsal, and positive family history. 9,18 Plain radiographs are used to grade the severity of hallux rigidus. 1,9,12 In selecting a treatment modality the clinician should consider the natural history of the disease.…”

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confidence: 99%

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Short-term Efficacy of Ultrasonographic Guidance for Intra-articular Corticosteroid Injection in Hallux Rigidus: A Single-Blind Randomized Controlled Trial

et al. 2021

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Background: Multiple considerations should be taken before standardizing a clinical procedure such as efficacy, safety, or the cost. The aim of this study was to compare the effects of landmark-guided vs ultrasonography-guided intra-articular injection of corticosteroid into the first metatarsophalangeal joint cavity to reduce pain and dysfunction in patients with hallux rigidus. Methods: We carried out a single-blind randomized controlled trial with 2 parallel arms in an outpatient clinic affiliated with a medical university. In total, 50 participants (35 women) with the mean (SD) age of 49.8 (10.3) years were randomly allocated to landmark-guided or ultrasonography-guided groups (each n = 25). Each patient received a single intra-articular injection of 40-mg methylprednisolone plus 1 mL lidocaine into the affected first metatarsophalangeal joint. The primary outcome was joint pain and the secondary outcome was the American Orthopaedic Foot & Ankle Society score. We measured the outcomes at baseline and 2 and 6 weeks after the intervention. Results: Six weeks after the injections, there were no statistically significant differences between the study groups in pain reduction and increase in the American Orthopaedic Foot & Ankle Society scores ( P = .131 and .241, respectively). We did not find any complications for the injections in both groups. There were statistically significant changes within each group in pain and the scores for the landmark ( P < .001, and P = .007), and ultrasonography groups (both P < .001). Conclusion: Landmark guidance is as effective as ultrasonographic guidance for intra-articular injection in patients with hallux rigidus. A single intra-articular injection of 40 mg methylprednisolone plus 1 mL lidocaine is an efficient and safe therapeutic measure for decreasing joint pain and maintaining its function, at least for 6 weeks. Level of Evidence: Level I, high-quality prospective randomized study.

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Hallux Rigidus: A Comprehensive Review

Slullitel,

Lopez

2022

Foot and Ankle Disorders

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Surgical options for hallux rigidus: state of the art and review of the literature

Cited by 59 publications

References 49 publications

Patient-reported outcomes of joint-preserving surgery for moderate hallux rigidus: a 1-year follow-up of 296 patients from Swefoot

Patient-reported outcomes of joint-preserving surgery for moderate hallux rigidus: a 1-year follow-up of 296 patients from Swefoot

Short-term Efficacy of Ultrasonographic Guidance for Intra-articular Corticosteroid Injection in Hallux Rigidus: A Single-Blind Randomized Controlled Trial

Hallux Rigidus: A Comprehensive Review

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