Functional outcomes following ceramic total joint replacement for hallux rigidus

Area of Science:

• Orthopaedic Surgery
• Biomaterials Science

Background:

• Osteoarthritis of the hallux metatarsophalangeal (MTP) joint significantly impacts patient mobility and quality of life.
• Ceramic arthroplasty presents a potential treatment option for MTP joint osteoarthritis.

Purpose of the Study:

• To evaluate the functional outcomes of ceramic arthroplasty in treating hallux MTP joint osteoarthritis.
• To assess patient satisfaction, joint function, and radiographic findings post-surgery.

Main Methods:

• A cohort of 37 patients undergoing press-fit ceramic joint arthroplasty was retrospectively analyzed.
• Evaluations included joint range of motion, gait pressure analysis, radiographs, American Orthopaedic Foot and Ankle Society (AOFAS) scores, Hallux Metatarsal Phalangeal-Interphalangeal (HMPI) index, and visual analogue pain scales.

Main Results:

• Mean follow-up was 33 months, with 92% patient satisfaction.
• Over 90% of patients achieved good to excellent AOFAS and HMPI scores.
• Significant reduction in hallux pressure at toe-off was observed (7.1 to 3.5 N cm⁻²).
• Six implants showed lucent lines >2mm, with three experiencing component subsidence; no correlation with patient outcomes was found.
• Three patients required revision surgery, and one had a transient wound infection.

Conclusions:

• Ceramic total MTP joint arthroplasty demonstrates good to excellent clinical results.
• The clinical significance of progressive lucencies and potential implant subsidence warrants further investigation with longer follow-up.