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Republication of "Current Concepts Review: Hallux Rigidus".

Michael R Anderson1, Bryant S Ho2, Judith F Baumhauer3

  • 1Summit Orthopedics, Woodbury, MN, USA.

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|July 28, 2023
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Summary
This summary is machine-generated.

Hallux rigidus, a common cause of foot pain, involves stiff, painful first MTP joint arthritis. While cheilectomy and new implants show promise, joint fusion remains the gold standard for advanced cases.

Keywords:
forefoot disordershallux rigidus

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Area of Science:

  • Orthopedics
  • Podiatry
  • Rheumatology

Background:

  • First metatarsophalangeal (MTP) joint arthritis, or hallux rigidus, is a prevalent and debilitating condition causing significant foot pain in adults.
  • This condition is marked by cartilage degeneration and the formation of osteophytes, leading to joint stiffness and pain.

Purpose of the Study:

  • To review current treatment modalities for hallux rigidus, ranging from conservative measures to surgical interventions.
  • To evaluate the efficacy of cheilectomy and novel hemi-arthroplasty implants compared to arthrodesis for advanced hallux rigidus.

Main Methods:

  • Review of conservative management strategies including activity modification, footwear, orthotics, medications, and steroid injections.
  • Analysis of surgical options such as cheilectomy for mild cases and polyvinyl alcohol hemi-arthroplasty for advanced hallux rigidus.
  • Comparison of outcomes with arthrodesis (joint fusion) as the established gold standard for severe hallux rigidus.

Main Results:

  • Conservative treatments and cheilectomy offer relief for mild hallux rigidus and dorsal impingement pain.
  • Polyvinyl alcohol hemi-arthroplasty demonstrates promising early to midterm results for advanced hallux rigidus.
  • Arthrodesis of the first MTP joint is considered the gold standard for advanced hallux rigidus due to unpredictable outcomes with earlier joint replacement implants.

Conclusions:

  • Treatment for hallux rigidus should be tailored to disease severity, with conservative options and cheilectomy suitable for milder presentations.
  • While new implant technologies show potential, arthrodesis remains the most reliable surgical option for advanced hallux rigidus.
  • Further research is needed to establish the long-term efficacy of joint replacement implants for hallux rigidus.