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Hallux rigidus

Timothy R Daniels, Alastair S E Younger, Murray J Penner, Kevin J Wing, Sara Lyn Miniaci-Coxhead, Ellie Pinsker, Mark Glazebrook
BACKGROUND: Hallux rigidus is the most common arthritic condition of the foot. A randomized clinical trial of first metatarsophalangeal (MTP) joint hemiarthroplasty with a polyvinyl alcohol (PVA) hydrogel implant (Cartiva) demonstrated pain relief and functional outcomes equivalent to first MTP arthrodesis at 2 years postoperation, with no cases of implant fragmentation, wear, or bone loss. We prospectively determined 5-year outcomes of first MTP hemiarthroplasty with the PVA hydrogel implant...
November 30, 2016: Foot & Ankle International
Judith F Baumhauer, Michele Marcolongo
Various methods of repairing damaged articular cartilage surfaces have been proposed and a variety of implant materials have been tried in an attempt to decrease pain and improve function after cartilage repair. The hydrogel made of polyvinyl alcohol and saline is a unique material used as an implant in the great toe for advanced stage arthritis.
December 2016: Foot and Ankle Clinics
Corina Nüesch, Annegret Mündermann, Monika Horisberger
BACKGROUND: Arthroplasty of the first metatarsophalangeal joint is an alternative treatment option for end-stage hallux rigidus to the current gold standard of arthrodesis. The aim of this study was to investigate the mid-term functional outcome of an anatomically shaped prosthesis for the first metatarsophalangeal joint using pedobarography. METHODS: Ten patients (12 affected feet; age at surgery: 62.1 (SD: 7.2) years) were investigated preoperatively and 52 (SD: 3) months postoperatively using pedobarography (EMED, novel GmbH, Munich, Germany)...
November 10, 2016: Clinical Biomechanics
Łukasz M Paczesny, Jacek Kruczyński
INTRODUCTION: The use of metatarso-phalangeal joint arthroscopy in the treatment of osteochondritis dissecans was first described in 1988. The technique produces good results. However, it can be difficult to enter a joint when it is deformed by degenerative disease. Sonography is a modern visualisation modality which can be used in orthopaedic surgery. AIM: To describe a method of intraoperative sonographic navigation during first metatarso-phalangeal joint arthroscopy...
2016: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
John Grice, Daniel Marsland, George Smith, James Calder
BACKGROUND: Corticosteroid injections have been used for a variety of foot and ankle pathologies over the years, and our aim was to evaluate the efficacy and safety of them in our clinic. MATERIALS AND METHODS: We performed a retrospective review of notes and a telephone questionnaire on the clinical outcome of all patients who underwent a corticosteroid injection of the foot or ankle in a year. All procedures were performed in an outpatient setting by a consultant musculoskeletal radiologist using either ultrasound or X-ray guidance and had a minimum of 2 years of follow-up...
September 25, 2016: Foot & Ankle International
Barry Rose, Kumar Kunasingam, Tristan Barton, James Walsh, Karen Fogarty, Andrew Wines
: Local anesthetic use for wound infusions, single injection, and continuous nerve blocks for postoperative analgesia is well established. No study has investigated the effect of a continuous block of the saphenous and superficial peroneal nerves at the level of the ankle joint following first ray surgery. A double blind randomized controlled trial was designed. One hundred patients with hallux valgus and rigidus requiring surgical correction were recruited and randomized to receive a postoperative continuous infusion at the ankle of normal saline or ropivacaine for 24 hours...
September 9, 2016: Foot & Ankle Specialist
Michel Chraim, Peter Bock, Hamza M Alrabai, Hans-Jörg Trnka
AIMS: This study was aimed to study the arthrodesis of the first metatarsophalangeal joint using an oblique interfragmentary lag screw and dorsal plate as an effective option for the treatment of hallux rigidus. Few researchers have studied the outcome of this surgical method over a long follow-up period. PATIENTS AND METHODS: We performed a retrospective review of 60 patients status post arthrodesis of the first metatarsophalangeal joint. The mean age was 68.5 years and average follow-up lasted for 47...
August 20, 2016: International Orthopaedics
A H Sott
First metatarsophalangeal joint arthrodesis plays a significant role in the management of symptomatic hallux rigidus/osteoarthritis of the 1st metatarsophalangeal joint. Several open and few percutaneous techniques have been described in the literature. This article describes and discusses a percutaneous technique that has been successfully used to achieve a pain-free stable and functional 1st metatarsophalangeal joint. All aspects of surgical indication and operative technique and details of patient-reported outcomes are presented with a referenced discussion...
September 2016: Foot and Ankle Clinics
Aisha Razik, A H Sott
Hallux rigidus is a degenerative condition leading to arthritis of the first metatarsophalangeal joint. Cheilectomy is a surgical procedure that is used in the treatment of hallux rigidus. It removes dorsal and dorsomedial or dorsolateral osteophytes, primarily relieving the impingement at the first metatarsophalangeal joint, which causes patients pain. The minimally invasive technique has proven to be an excellent technique to remove bony spurs to relieve symptoms with minimal surgical complications and fast recovery time...
September 2016: Foot and Ankle Clinics
Gaston Slullitel, Valeria López, Maximiliano Seletti, Juan P Calvi, Carla Bartolucci, Gustavo Pinton
Surgical treatment of moderate hallux rigidus remains controversial and the optimal surgical technique has yet to be defined. Decompressive metatarsal osteotomy is one of the procedures available; however, one of the potential drawbacks is the effect of the metatarsal shortening. We evaluated the global effect of the decompressive metatarsal osteotomy, accounting for the metatarsal index. We retrospectively evaluated 78 patients with stage II and III hallux rigidus who had undergone Youngswick osteotomy and analyzed their outcomes according to the metatarsal index...
November 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
N D Clement, D MacDonald, G F Dall, I Ahmed, A D Duckworth, H S Shalaby, J McKinley
AIMS: To examine the mid-term outcome and cost utility of the BioPro metallic hemiarthroplasty for the treatment of hallux rigidius. PATIENTS AND METHODS: We reviewed 97 consecutive BioPro metallic hemiarthroplasties performed in 80 patients for end-stage hallux rigidus, with a minimum follow-up of five years. There were 19 men and 61 women; their mean age was 55 years (22 to 74). No patient was lost to follow-up. RESULTS: A total of 12 patients (15 first metatarso-phalangeal joints (MTPJs)) required a revision; one for infection, two for osteolysis and 12 for pain...
July 2016: Bone & Joint Journal
E Circi, T Tuzuner, E Sukur, A Baris, E Kanay
BACKGROUND: This study looks at the failure and complications arising secondary to resurfacing and hemi-arthroplasty done at the metatarsal head in patients with hallux rigidus. Our report includes a review of the relevant literature to verify the validity of our techniques. MATERIALS AND METHODS: We performed metatarsal head resurfacing with hemi-arthroplasty using the HemiCap(®), on 12 patients with hallux rigidus between the dates of March 2010 and October 2013...
August 2016: Musculoskeletal Surgery
Adam Bitterman, Cristin Mathew, Milap Patel, James P Gurtowski
Metatarsophalangeal (MTP) joint osteoarthritis (OA), also known as hallux rigidus (HR), is the most common degenerative arthropathy of the foot and is often the result of trauma. There are multiple methods of addressing the patient's pain and limited function. Arthrodesis is the gold standard to manage severe MTP arthritis with a highly significant union rate. With various techniques of arthrodesis available, ranging from cannulated screw fixation, Kirschner wires, as well as plate and screw fixation, the orthopedic surgeon has multiple modalities to address this ailment; however, when these fail due to infection, the armament is limited...
2016: Curēus
Mehmet Orçun Akkurt, Hakan Şeşen, Mahmut Özdemir, Mehmet Faruk Çatma, İsmail Demirkale
Complications of first metatarsophalangeal joint metallic arthroplasty are well known. However, the resulting shortening of the metatarsals can lead to transverse metatarsalgia or medial column pain at the metatarsophalangeal joints by creating Morton's toe/foot, which increases pressure on the second metatarsal head. The effect of the functional length ratio of the first and second metatarsals on pain and patient satisfaction has not been rigorously evaluated. We evaluated the effect of the first/second metatarsal ratio on patient satisfaction with first metatarsophalangeal joint metallic arthroplasty...
July 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Monika Horisberger, David Haeni, Heath B Henninger, Victor Valderrabano, Alexej Barg
BACKGROUND: The current gold standard in the treatment of severe hallux rigidus is arthrodesis of the first metatarsophalangeal (MTP-I) joint. We present the results of a new 3-component MTP-I prosthesis. We determined (1) the intraoperative and perioperative complications; (2) survivorship of prosthesis components and rate of secondary surgeries for any reason; (3) prosthetic component stability and radiographic alignment; (4) the degree of pain relief; and (5) the midterm functional outcomes including radiographic range of motion (ROM)...
July 2016: Foot & Ankle International
Andrew D Elliott, Andrew J Borgert, Thomas S Roukis
Forty-seven patients (50 feet) underwent surgical intervention for symptomatic hallux rigidus from February 1998 to April 1999. Thirty-eight patients (41 feet) returned at 1 year for a follow-up evaluation. Of these 38 patients, 20 (21 feet) returned for the 15-year follow-up evaluation. Subjective evaluations were performed using the modified American Orthopaedic Foot and Ankle Surgery hallux metatarsophalangeal-interphalangeal 100-point scale. Long-term postoperative objective physical examination and radiographic analysis were performed...
May 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Harold Vogler, Ryan B Rigby
Surgical intervention for hallux rigidus could be necessitated when conservative attempts fail to alleviate pain and dysfunction. Controversy exists as to which procedure is ideal and will provide lasting relief of hallux rigidus pain. Many arguments have been made for and against hemi-implant arthroplasty. We advocate the use of a low-profile hemimetallic endoprosthesis (Metasurg(®)) and present our technique of using a reamer to sculpt the articular surface of the metatarsal head when necessary. We further advocate for minimal resection of the phalangeal base when using a low-profile device to maintain the soft tissue periarticular intrinsics...
May 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Judith F Baumhauer, Dishan Singh, Mark Glazebrook, Chris Blundell, Gwyneth De Vries, Ian L D Le, Dominic Nielsen, M Elizabeth Pedersen, Anthony Sakellariou, Matthew Solan, Guy Wansbrough, Alastair S E Younger, Timothy Daniels
BACKGROUND: Although a variety of great toe implants have been tried in an attempt to maintain toe motion, the majority have failed with loosening, malalignment/dislocation, implant fragmentation and bone loss. In these cases, salvage to arthrodesis is more complicated and results in shortening of the ray or requires structural bone graft to reestablish length. This prospective study compared the efficacy and safety of this small (8/10 mm) hydrogel implant to the gold standard of a great toe arthrodesis for advanced-stage hallux rigidus...
May 2016: Foot & Ankle International
Engin Cetinkaya, Merter Yalcinkaya, Sami Sokucu, Abdulkadir Polat, Ufuk Ozkaya, Atilla Sancar Parmaksizoglu
BACKGROUND: This study aimed to analyze the functional results of cheilectomy in the surgical treatment of grade III hallux rigidus and to evaluate whether cheilectomy is a preferable first-line treatment over other surgical methods. METHODS: Of 29 patients with moderate daily physical activity who underwent cheilectomy between 2009 and 2012 on being diagnosed as having grade III hallux rigidus according to the Coughlin-Shurnas grading system, 21 patients (14 women and 7 men; mean age, 59...
January 2016: Journal of the American Podiatric Medical Association
MaCalus V Hogan, Sriniwasan B Mani, Jeremy Y Chan, Huong Do, Jonathan T Deland, Scott J Ellis
BACKGROUND: There is a clear call for improved patient-centered outcomes. The Foot and Ankle Outcome Score (FAOS) is a region-specific patient-reported measure that has been validated for a number of foot and ankle diagnoses, but not hallux rigidus. QUESTIONS/PURPOSES: The aim of this study was to validate the FAOS in patients with hallux rigidus. METHODS: From 2007 to 2013, 211 patients with hallux rigidus (HR) were included in the study...
February 2016: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
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