Comparing First Metatarsophalangeal Joint Flexibility in Hallux Rigidus Patients Pre- and Postcheilectomy Using a...

Area of Science:

• Orthopedic Surgery
• Biomechanics
• Podiatry

Background:

• Hallux rigidus (HR) is a degenerative joint disease affecting the first metatarsophalangeal (MTP) joint, characterized by pain and stiffness.
• Radiographic severity in HR often does not correlate with clinical symptoms.
• A validated flexibility device measures MTP joint mobility, offering a novel assessment tool.

Purpose of the Study:

• To compare joint flexibility in hallux rigidus patients before and after cheilectomy (with or without proximal phalanx osteotomy).
• To evaluate the effectiveness of surgical intervention in restoring MTP joint motion and improving patient-reported outcomes.

Main Methods:

• A single-center prospective study included adult HR patients undergoing cheilectomy or cheilectomy with Moberg osteotomy.
• Patients underwent pre- and postoperative testing using a validated flexibility protocol, measuring early/late flexibility, laxity torque, and angle.
• Foot and Ankle Outcomes Scores (FAOS) were collected pre- and postoperatively.

Main Results:

• Significant improvements were observed in early and late flexibility, laxity angles, laxity torque, and maximum dorsiflexion post-surgery (P < .05).
• Preoperative flexibility and motion parameters differed significantly from controls, but postoperative early flexibility approached normal levels (P > .279).
• FAOS scores for pain, symptoms, sport, and quality of life showed significant improvement after surgery.

Conclusions:

• Cheilectomy surgery leads to significant improvements in MTP joint flexibility and clinical outcomes for HR patients.
• While postoperative flexibility may not fully reach normal control levels, the functional and symptomatic gains are substantial.
• The validated flexibility device is a valuable tool for assessing surgical outcomes in HR and can be used in future research.