Treatment of End-Stage Hallux Rigidus Using Total Joint Arthroplasty: A Short-Term Clinical Study

The treatment of advanced hallux rigidus remains controversial. Only a few studies have analyzed the short- and mid-term results of metatarsophalangeal (MTP) joint arthroplasty to treat patients with advanced hallux rigidus. We present the short-term follow-up results of patients who underwent MTP joint arthroplasty. We reviewed the medical records of 15 consecutive patients (3 males and 12 females) who had had grade 3 or 4 hallux rigidus diagnosed according to the Coughlin and Shurnas classification. The age range at surgery was 44 to 74 (mean 61.6) years. The mean follow-up period was 21.7 (range 18 to 28) months. The mean change in the overall American Orthopaedic Foot and Ankle Society Hallux-First Ray scale score was from 26.9 ± 2.3 preoperatively to 78.7 ± 8.8 postoperatively (p < .005). The mean change in the overall visual analog scale score was from 8.3 ± 0.8 preoperatively to 1.7 ± 0.7 postoperatively (p < .005). The mean preoperative first MTP joint range of motion was 22.3° ± 7.7° (range 15° to 45°), which had increased to 77° (range 65° to 90°) at the final follow-up visit. No patient required revision surgery or removal. These results indicate that for patients with advanced-stage hallux rigidus refractory to conservative treatment, total joint arthroplasty can lead to good satisfaction and good functional results in the short term.