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Published on: February 17, 2018
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Keller's arthroplasty for hallux rigidus: A systematic review
E Artioli1, A Mazzotti2, S Zielli1
1IRCCS Istituto Ortopedico Rizzoli, 1st Orthopaedic and Traumatologic Clinic, Via Giulio Cesare Pupilli 1, 40136 Bologna, Italy.
Summary
Keller arthroplasty (KA) offers good outcomes for moderate-to-severe hallux rigidus in older adults. However, limited evidence exists on its safety and efficacy, necessitating careful patient selection to minimize complications like metatarsalgia.
Area of Science:
- Orthopedic Surgery
- Foot and Ankle Surgery
Background:
- Hallux rigidus treatment involves various surgical options.
- Keller arthroplasty (KA), a joint-sacrificing procedure from 1904, is debated regarding its suitability and mini-invasive trends.
Purpose of the Study:
- To review Keller arthroplasty outcomes for hallux rigidus.
- To identify conditions where Keller arthroplasty remains a viable treatment option.
Main Methods:
- A systematic review of 17 retrospective studies involving 508 patients.
- Data extracted included population demographics, surgical indications, techniques, outcomes, and complications.
Main Results:
- The mean patient age was 55 years, with moderate-to-severe hallux rigidus.
- Good clinical and radiological outcomes were reported for Keller arthroplasty.
- Metatarsalgia was the most frequent complication, occurring in 12% of patients.
Conclusions:
- Keller arthroplasty may be suitable for middle-aged and elderly patients with moderate-to-severe hallux rigidus.
- Limited evidence exists regarding the technique's true efficacy and safety.
- Accurate patient selection is crucial to mitigate potential complications.
