Short-term clinical outcomes after first metatarsal head resurfacing hemiarthroplasty for late stage hallux rigidus
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The purpose of the present study was to evaluate the short-term results of metatarsal head resurfacing hemiarthroplasty in the treatment of advanced hallux rigidus. We reviewed 14 consecutive patients (5 males [35.71%], 9 females [64.29%]; mean age, 58.7 +/- 7.4 years). These patients underwent first metatarsal head resurfacing hemiarthroplasty (HemiCAP (R)) for hallux rigidus from March 2010 to September 2012 at our institution. According to the Coughlin and Shurnas clinical and radiographic classification, 10 feet (71.43%) were classified as grade III and 4 (28.57%) as grade IV. We clinically rated all patients before surgery and at the final follow-up visit using the American Orthopaedic Foot and Ankle Society hallux metatarsophalangeal-interphalangeal scale, the visual analog scale for pain, and first metatarsophalangeal joint (MTPJ) range of motion. The mean follow-up duration was 24.2 +/- 7.2 (range 12 to 36) months. The mean preoperative hallux metatarsophalangealinterphalangeal scale score was 33.9 +/- 9.8 (range 22 to 59), and it increased to 81.6 +/- 10.1 (range 54 to 96; p <.05) postoperatively. The mean preoperative 10-cm visual analog scale for pain score was 8.4 +/- 0.9 (range 7 to 10), which decreased to 1.21 +/- 1.2 (range 0 to 5; p <.05) postoperatively. The mean preoperative MTPJ range of motion was 22.8 degrees +/- 7.7 degrees (range 15 degrees to 45 degrees), which increased to 69.6 degrees +/- 11.8 degrees (range 50 degrees to 90 degrees; p <.05) postoperatively. None of the 14 patients experienced component malalignment or loosening, infection, or neurovascular compromise during the follow-up period. One patient (7.14%) experienced postoperative pain and subsequently underwent first MTPJ arthrodesis. From the results of our investigation, first MTPJ arthroplasty is an effective treatment modality that can reduce pain and increase motion in the case of advanced hallux rigidus.