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Hemiarthroplasty for Hallux Rigidus: Mid-Term Results
Daniel Gheorghiu1, Claire Coles2, Jordi Ballester1
1Trauma and Orthopaedic Surgeon, Whiston Hospital, Liverpool, England.
Summary
First metatarsophalangeal joint hemiarthroplasty using the HemiCAP prosthesis showed mixed results for hallux rigidus patients. While some experienced pain relief, many reported persistent pain and limited movement, indicating potential for improvement with prosthesis modifications.
Area of Science:
- Orthopedics
- Podiatry
- Biomedical Engineering
Background:
- Hallux rigidus is a degenerative arthritis of the first metatarsophalangeal joint.
- It causes pain, stiffness, and reduced dorsiflexion, impacting mobility.
- Traditionally treated with arthrodesis, new joint-sparing options like hemiarthroplasty are emerging.
Purpose of the Study:
- To evaluate the clinical and radiological outcomes of first metatarsophalangeal joint hemiarthroplasty using the HemiCAP prosthesis.
- To assess patient satisfaction and functional improvement in hallux rigidus patients.
Main Methods:
- Retrospective review of 11 patients (12 feet) who underwent HemiCAP hemiarthroplasty.
- Postoperative assessment using American Orthopaedic Foot and Ankle Society (AOFAS) and Foot and Ankle Disability Index (FADI) scores.
- Clinical and radiological evaluation at a mean 47-month follow-up.
Main Results:
- Mean AOFAS score of 66.5 and mean FADI score of 63.7.
- 41.7% of patients were pain-free, while 58.3% reported some level of pain.
- 42% showed no radiographic subsidence; 58% had a mean subsidence of 2.71 mm.
Conclusions:
- Hemiarthroplasty with the HemiCAP prosthesis offers a potential alternative to arthrodesis for hallux rigidus.
- Outcomes suggest limited range of motion and persistent pain in a significant portion of patients.
- Modifications to the prosthesis, such as a dorsal flange, may enhance dorsiflexion and patient outcomes.
