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Intermediate-term results following first metatarsal cheilectomy
Bradly W Bussewitz1, Macaira M Dyment, Christopher F Hyer
1Orthopedic Foot & Ankle Center, Westerville, OH, USA. ofacresearch@orthofootankle.com
Foot & Ankle Specialist
|April 23, 2013
Summary
Cheilectomy offers reliable, lasting relief for hallux rigidus (degenerative joint disease of the first MTPJ). This procedure effectively manages early-stage foot arthritis, delaying or avoiding more invasive joint surgeries.
Area of Science:
- Orthopedic Surgery
- Podiatric Medicine
- Biomechanical Engineering
Background:
- Hallux rigidus is degenerative joint disease (DJD) affecting the first metatarsal phalangeal joint (MTPJ).
- It represents the most common DJD in the foot and is the second most frequent great toe pathology after hallux valgus.
- Cheilectomy aims to alleviate pain and improve MTPJ motion.
Purpose of the Study:
- To evaluate the longevity of cheilectomy outcomes.
- To determine the time frame before patients require subsequent arthrodesis or other joint-destructive procedures after cheilectomy.
- To assess the reliability and lasting results of cheilectomy for specific stages of MTPJ DJD.
Main Methods:
- Retrospective analysis of 189 cheilectomy procedures.
- Mean radiographic follow-up of 235 days.
- Mean chart review follow-up of 1184 days (3.2 years).
Main Results:
- Only 2 arthrodeses were performed after cheilectomy.
- 5 repeat cheilectomies and 1 interpositional arthroplasty were noted.
- The study indicates a low rate of subsequent major joint-destructive procedures.
Conclusions:
- Cheilectomy provides reliable, intermediate-term results for stages 1, 2, and 3 of first MTPJ DJD.
- The procedure demonstrates lasting efficacy, often delaying or eliminating the need for more invasive surgical interventions.
- Cheilectomy is an appropriate treatment option for hallux rigidus, offering sustained pain relief and improved joint function.