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Hallux rigidus. Excisional arthroplasty.

W G Hamilton1, C E Hubbard

  • 1Department of Orthopedic Surgery, St. Luke's Roosevelt Hospital, New York, New York, USA.

Foot and Ankle Clinics
|March 10, 2001
PubMed
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Capsular interposition arthroplasty offers predictable pain relief for severe hallux rigidus. Careful surgical technique and patient selection lead to good outcomes, though some may need orthoses for transfer metatarsalgia.

Area of Science:

  • Orthopedic Surgery
  • Podiatric Medicine
  • Musculoskeletal Research

Background:

  • Hallux rigidus is a degenerative condition affecting the first metatarsophalangeal (MTP) joint.
  • Severe hallux rigidus (Grade III) often leads to significant pain and functional limitation.
  • Surgical options for severe hallux rigidus include arthrodesis and joint-preserving procedures.

Purpose of the Study:

  • To evaluate the efficacy of capsular interposition arthroplasty for treating severe hallux rigidus.
  • To identify key surgical factors contributing to successful outcomes.
  • To assess the incidence of postoperative complications, specifically transfer metatarsalgia.

Main Methods:

  • The study retrospectively reviewed patients with Grade III hallux rigidus who underwent capsular interposition arthroplasty.

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  • Surgical technique involved attention to metatarsal length, proximal phalanx length, and use of dorsal capsule/EHB tendon.
  • Outcomes were assessed using objective and subjective measures, including complication rates.

    • Main Results:

    • Capsular interposition arthroplasty demonstrated predictable pain relief in carefully selected patients.
    • Good to excellent objective and subjective results were achieved with meticulous surgical technique.
    • Approximately 30% of patients experienced transfer metatarsalgia, potentially requiring orthoses.

    Conclusions:

    • Capsular interposition arthroplasty is a viable alternative to first MTP joint arthrodesis for advanced hallux rigidus.
    • Attention to surgical details is crucial for optimizing outcomes.
    • Patient selection and awareness of potential complications like transfer metatarsalgia are important considerations.