The long-term patient focused outcomes of the Keller's arthroplasty for the treatment of hallux rigidus

Coutts, Andrew; Kilmartin, Timothy E.; Ellis, Mairghread Jh

doi:10.1016/j.foot.2012.02.008

Cited by 19 publications

(4 citation statements)

References 31 publications

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“…Only 3 studies reported AOFAS-HMI scores ranging between 83 and 89 points with a wide spread in follow-up from 14 months to 23 years. 15,34,43,44 Our results are consistent with these studies, which showed that the good midterm results of a Keller’s arthroplasty remain stable over a long time. In addition, the fear of having a nonfunctional first ray resulting in limitations and/or pain was not proved with these results.…”

Section: Discussionsupporting

confidence: 91%

“…In the literature, several studies described outcome after MTP1 arthrodesis or cheilectomy for HR, where only a few studies evaluated the outcome after Keller's arthroplasty. 5,15,34,43,44 At the moment, only 2 studies have investigated the outcome after one of these interventions with a follow-up duration longer than 10 years. 9,44,50 The aim of this comparative follow-up study was to assess clinical and radiographic outcome after cheilectomy, Keller's arthroplasty, and arthrodesis in patients treated for HR after a very long follow-up period.…”

Section: Introductionmentioning

confidence: 99%

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Long-term Effects of Cheilectomy, Keller’s Arthroplasty, and Arthrodesis for Symptomatic Hallux Rigidus on Patient-Reported and Radiologic Outcome

et al. 2020

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Background: Several operative interventions are available to alleviate pain in hallux rigidus, and the optimal operative technique is still a topic of debate among surgeons. Three of these are arthrodesis, cheilectomy, and Keller’s arthroplasty. Currently, it is unclear which intervention yields the best long-term result. The aim of this study was to assess which of these interventions performed best in terms of patient-reported outcome, pain scores, and disease recurrence at long-term follow-up. Methods: These data are the follow-up to the initial study published in 2006. In the original study, 73 patients (n = 89 toes) with symptomatic hallux rigidus were recruited and underwent first metatarsophalangeal joint arthrodesis (n = 33 toes), cheilectomy (n = 28 toes), or Keller’s arthroplasty (n = 28 toes). Outcome measures were AOFAS hallux metatarsophalangeal-interphalangeal (HMI) score, and pain was assessed with a visual analog scale (VAS) at a mean follow-up period of 7 years. Patients of the original study were identified and invited to participate in the current study. Data were collected in the form of AOFAS-HMI score, VAS pain score, Manchester-Oxford Foot Questionnaire (MOXFQ), and Forgotten Joint Score (FJS-12). In addition, a clinical examination was performed and radiographs were obtained. Data were available for 37 patients (45 toes), with a mean follow-up period over 22 years. Results: AOFAS-HMI and VAS pain score improved during follow-up only in arthrodesis patients. Furthermore, no statistically significant differences in clinical and patient-reported outcome were detected between groups based on AOFAS-HMI, VAS pain, MOXFQ, or FJS-12. However, clinically important differences in patient-reported outcomes and pain scores were detected, favoring arthrodesis. Radiographic disease progression was more evident after cheilectomy compared with Keller’s arthroplasty. Conclusion: Arthrodesis, cheilectomy, and Keller’s arthroplasty are 3 sucessful operative interventions to treat symptomatic hallux rigidus. Because clinically important differences were detected and symptoms still diminish many years after surgery, a slight preference was evident for arthrodesis. Level of Evidence: Level III, comparative study.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Long-term Effects of Cheilectomy, Keller’s Arthroplasty, and Arthrodesis for Symptomatic Hallux Rigidus on Patient-Reported and Radiologic Outcome

et al. 2020

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“…Tiihonen et al (12) did not report any deformities or metatarsalgia in 1-year follow-up. Our 9-year case series did not show similar problems as those seen in the Brandes–Keller procedure in long-term follow-up (6). In this study, the bone resections were performed in both sides of phalangeal and metatarsal bones or only metatarsal, depending on the arthritis of the bones.…”

Section: Discussionsupporting

confidence: 59%

“…However, it is well known nowadays that resection arthroplasty carries a high risk of postoperative metatarsalgia due to the instability and poor function of the MTP-1 joint. Therefore, there is a need to research new techniques that will retain the mobility of the MTP-1 joint after HV or HR surgery (6).…”

Section: Background and Aimsmentioning

confidence: 99%

Interpositional Arthroplasty of the First Metatarsophalangeal Joint with Bioresorbable Pldla Implant in the Treatment of Hallux Rigidus and Arthritic Hallux Valgus: A 9-Year Case Series Follow-Up

et al. 2019

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Background and Aims: The interpositional arthroplasty was developed to retain foot function and to relieve pain due to the arthritis of the first metatarsophalangeal joint. The bioabsorbable poly-L-D-lactic acid RegJoint® interpositional implant provides temporary support to the joint, and the implant is subsequently replaced by the patient’s own tissue. In this study, we retrospectively examined the results of the poly-L-D-lactic acid interpositional arthroplasty in a 9-year follow-up study among patients with hallux valgus with end-stage arthrosis or hallux rigidus. Material and Methods: Eighteen patients and 21 joints underwent interpositional arthroplasty using the poly-L-D-lactic acid implant between February 1997 and October 2002 at Tampere University Hospital. Of these, 15 (83.3%) (21 joints) patients were compliant with clinical examination and radiographic examination in long-term (average 9.4 years) follow-up. The mean age of the patients was 48.3 (from 28 to 67) years at the time of the operation. Six patients underwent the operation due to arthritic hallux valgus and nine patients due to hallux rigidus. Results: The mean Ankle Society Hallux Metatarsophalangeal–Interphalangeal Scale and visual analogue scale (VAS) for pain scores improved after the operation in all patients. The decrease of pain (visual analogue scale) after the operation was statistically significant (77.5 vs 10.0; p < 0.001). Postoperative complications were observed in 3 (14.3%) joints of two hallux rigidus patients. For these patients, surgery had only temporarily relieved the pain, and they underwent reoperation with arthrodesis. Conclusion: In conclusion, interpositional arthroplasty using a poly-L-D-lactic acid implant yielded good results. This study indicates that the poly-L-D-lactic acid interpositional implant may be a good alternative for arthrodesis for treatment of end-stage degeneration of the first metatarsophalangeal joint.

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Foot and Ankle

Heyes

Mason

2021

Current Orthopaedic Practice

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The long-term patient focused outcomes of the Keller's arthroplasty for the treatment of hallux rigidus

Cited by 19 publications

References 31 publications

Long-term Effects of Cheilectomy, Keller’s Arthroplasty, and Arthrodesis for Symptomatic Hallux Rigidus on Patient-Reported and Radiologic Outcome

Long-term Effects of Cheilectomy, Keller’s Arthroplasty, and Arthrodesis for Symptomatic Hallux Rigidus on Patient-Reported and Radiologic Outcome

Interpositional Arthroplasty of the First Metatarsophalangeal Joint with Bioresorbable Pldla Implant in the Treatment of Hallux Rigidus and Arthritic Hallux Valgus: A 9-Year Case Series Follow-Up

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