Youngswick osteotomy for treatment of moderate hallux rigidus: Thirteen years without arthrodesis

Slullitel, Gastón; López, Valeria; Calvi, Juan Pablo; D’Ambrosi, Riccardo; Usuelli, Federico Giuseppe

doi:10.1016/j.fas.2019.11.008

Cited by 16 publications

(15 citation statements)

References 17 publications

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“…Surgical treatment options can be joint-preserving and joint-sacrificing procedures. 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.…”

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confidence: 99%

“…This procedure gives the possibility to address the hallux valgus deformity additionally. Even though studies have shown positive outcomes for both YOT and cheilectomy (Coughlin and Shurnas 2003, Sidon et al 2019, Slullitel et al 2019 there are few studies 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.…”

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confidence: 99%

“… 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 ).…”

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confidence: 99%

“… 2019 , Slullitel et al. 2019 ) there are few studies comparing these procedures. There is some evidence suggesting that cheilectomy has a higher frequency of revision surgery (Cullen et al.…”

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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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confidence: 99%

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confidence: 99%

“… 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 ).…”

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confidence: 99%

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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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“…Our study is to date the largest series dealing with shortening metatarsal osteotomies in the management of hallux rigidus, and we were able to get follow-up on 87 of 88 feet. With the work of Malerba et al, 24 Slullitel et al, 29,30 and Oloff and Jhala-Patel, 26 our patient series is one of the 5 series with the greatest length of follow-up. Having an independent reviewer for data collection increased the robustness of our results and limited bias.…”

Section: Discussionmentioning

confidence: 81%

Average 4-Year Outcomes of Distal Oblique First Metatarsal Osteotomy for Stage 1 to 3 Hallux Rigidus

Saur

Hernandes

Barouk³

et al. 2021

Foot Ankle Int.

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Background: Hallux rigidus is the second most frequent pathology of the first ray. Surgical options for degenerative metatarsophalangeal joint disease are either joint destructive or conservative procedures. The hypothesis was that oblique distal shortening osteotomy of the first metatarsal is an effective conservative technique for the management of stage 1 to 3 hallux rigidus. Methods: We conducted a retrospective cohort study of 87 feet with Coughlin and Shurnas’s stage 1-3 hallux rigidus, operated between 2009 and 2019. The cohort consisted in 72 patients (87 feet) with an average age of 57±9 (30/79) years; 22 of 87 (25.3%) feet had the first metatarsal surgery performed in isolation; 65 of 87 (74.7%) had concomitant forefoot procedures, including 31 of 87 (35.6%) with Akin phalangeal osteotomies and 34 of 87 (39.1%) with Moberg phalangeal osteotomies. We evaluated the American Orthopaedic Foot & Ankle Society (AOFAS) Scale, subjective satisfaction, joint amplitudes, shortening rate, and occurrence of postoperative complications with a mean follow-up of 51 months (16/134). Results: The AOFAS score increased from 54.2±11.3 (25/70) preoperatively to 92.2±7.8 (62/100) postoperatively ( P < .001). Patients reported excellent or good outcome in 95.4% of cases. The 40-point self-reported pain subscale score improved from 19.6 (± 10.0) to 37.4 (± 5.4), P < .001. The overall range of motion increased from 61±21 (20/110) degrees to 69±17 (35/120) degrees ( P < .001). The mean first metatarsal shortening rate (SRpo) was 9.6%. Neither the Coughlin grade, the metatarsal index, or the SRpo influenced the AOFAS score. At 6-month follow-up, 15 patients had transfer metatarsalgia compared with 5 at last follow-up without requiring another surgical procedure. The risk was not significantly different according to Coughlin's stage, preoperative metatarsal index, or SRpo. Conclusion: Oblique distal osteotomy of the first metatarsal for stage 1-3 hallux rigidus, often in combination with other first ray procedures, performed well during our follow-up time period, with a high subjective satisfaction rate and few complications. Level of Evidence: Level III, retrospective cohort study.

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Hallux Rigidus: A Comprehensive Review

Slullitel,

Lopez

2022

Foot and Ankle Disorders

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Youngswick osteotomy for treatment of moderate hallux rigidus: Thirteen years without arthrodesis

Cited by 16 publications

References 17 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

Average 4-Year Outcomes of Distal Oblique First Metatarsal Osteotomy for Stage 1 to 3 Hallux Rigidus

Hallux Rigidus: A Comprehensive Review

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