Functional and Radiographic Results of Hemiarthroplasty in the Treatment of Hallux Rigidus of the First Metatarsophalangeal Joint

Abstract

Objective: The purpose of this study was to evaluate changes in the radiological, clinical, and functional results following the application of hemiarthroplasty in patients with grade 3 or 4 first metatarsophalangeal joint osteoarthritis.

Methods: Twenty-one feet of nineteen patients who were who were diagnosed as grade 3 or 4 hallux rigidus and treated with hemiarthroplasty, between January 2013 and December 2015, were retrospectively evaluated. Functional results [visual analog scale (VAS) and American Orthopedic Foot and Ankle Society (AOFAS) scores, Short Form-12 (SF12) physical and mental scores], clinical results (ranges of dorsiflexion and plantar flexion), and radiological results (osteolysis, loosening, hallux valgus angles (HVA), and intermetatarsal angles (IMA)) were evaluated at their follow-up.

Results: The mean follow-up period was 24 (range: 12-66) months. The mean ranges of flexion was increased from 6 degrees (range: 0 degrees-20 degrees) to 8 degrees (range: 0 degrees-20 degrees) and ranges of extension from 4 degrees (range; 0 degrees-10 degrees) to 7 degrees (range: 0 degrees-30 degrees), postoperatively. Preoperative and postoperative values of the mean IMA (9 degrees vs. 11 degrees) and HVA (18 degrees vs. 13 degrees) did not change significantly. The mean AOFAS scores increased from 72 to 96 (p=0.003). The mean VAS, SF12-MCS, and SF12-PCS scores were 7.8 (range: 4-10), 42.7 (range: 33.8-55.7), and 51.1 (range, 36.7-61.2), postoperatively and comparisons to their preoperative values were not significant. Radiographic follow-up did not show findings of osteolysis around the prosthesis or loosening in any patient.

Conclusion: In the treatment of hallux rigidus with hemiarthroplasty, although postoperative range of movement was found to be limited, patient satisfaction and pain levels were improved in all patients.