The modified oblique keller capsular interpositional arthroplasty for hallux rigidus

Area of Science:

• Orthopaedic surgery
• Foot and ankle reconstruction
• Osteoarthritis treatment

Background:

• Hallux rigidus involves osteoarthritis and limited motion of the big toe.
• First metatarsophalangeal joint arthrodesis is a standard treatment for advanced stages.
• Patient preference for motion-sparing alternatives drives development of new procedures.

Purpose of the Study:

• To compare the clinical outcomes of modified Keller arthroplasty with first metatarsophalangeal joint arthrodesis.
• To evaluate range of motion, strength, and plantar pressures after both procedures.
• To assess the effectiveness of a motion-sparing technique for hallux rigidus.

Main Methods:

• A comparative cohort study involving ten patients (modified Keller arthroplasty) and twelve patients (arthrodesis).
• Assessment of clinical outcomes using American Orthopaedic Foot and Ankle Society scores.
• Measurement of joint range of motion, great toe strength, and plantar pressures via radiography.

Main Results:

• The modified Keller arthroplasty group showed significantly higher American Orthopaedic Foot and Ankle Society scores.
• The arthroplasty group retained significant passive (54 degrees) and active (30 degrees) range of motion.
• Plantar pressure was higher under the great toe in the arthrodesis group compared to the arthroplasty group.

Conclusions:

• Modified oblique Keller capsular interpositional arthroplasty provides motion-sparing benefits.
• Clinical outcomes are equivalent to first metatarsophalangeal joint arthrodesis.
• The procedure results in a more normal plantar pressure distribution during walking.