Free gracilis interposition arthroplasty for severe hallux rigidus

Area of Science:

• Orthopedic surgery
• Foot and ankle reconstruction

Background:

• Hallux rigidus management aims to reduce pain and enhance foot function.
• Traditional treatments like arthrodesis (fusion) are effective for pain but may be rejected by patients due to joint stiffness.
• Alternative methods such as silastic implants, excisional arthroplasty, and cheilectomy have limitations, with some yielding suboptimal long-term outcomes.

Purpose of the Study:

• To describe a novel surgical technique for severe hallux rigidus.
• To evaluate the efficacy of autologous interposition arthroplasty using a gracilis tendon graft.
• To provide a joint-preserving surgical option for active patients unwilling to undergo fusion.

Main Methods:

• A surgical technique involving autologous interposition arthroplasty was developed.
• A free ipsilateral gracilis tendon graft was utilized to reconstruct the first metatarsophalangeal joint.
• The procedure was performed on patients with severe hallux rigidus and moderate to high activity levels who opted against fusion.

Main Results:

• The study details a specific surgical approach for hallux rigidus.
• This technique offers an alternative to fusion for specific patient populations.
• The use of a gracilis tendon graft facilitates joint preservation and functional restoration.

Conclusions:

• Autologous interposition arthroplasty with a gracilis tendon graft presents a viable surgical option for severe hallux rigidus.
• This technique addresses the need for pain relief and functional improvement in active patients who wish to avoid joint fusion.
• It represents a promising joint-sparing alternative in the surgical management of hallux rigidus.