A Retrospective Study Assessing the Clinical Outcomes After Cheilectomy and Subchondroplasty for Hallux Rigidus.

Area of Science:

• Orthopedics
• Podiatry
• Surgical Innovation

Background:

• Hallux rigidus (HR) is osteoarthritis of the first metatarsophalangeal joint, causing pain and stiffness.
• Surgical intervention for HR is considered after non-operative treatments fail.
• Procedures for HR are categorized as joint-preserving (JP) or joint-sacrificing.

Purpose of the Study:

• To evaluate clinical outcomes of cheilectomy for HR.
• To assess outcomes of cheilectomy combined with subchondroplasty (SCP) for HR.
• To compare the efficacy of these two surgical approaches for hallux rigidus.

Main Methods:

• Retrospective analysis of 19 patients (20 feet) who underwent cheilectomy for HR between 2017 and 2022.
• Pre-operative radiographs and clinical notes were used for HR grading.
• Functional outcomes were measured using Visual Analog Scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) scores, along with MTP joint dorsiflexion.

Main Results:

• A significant increase in first MTP joint dorsiflexion by 27.2 degrees (p<0.0001).
• Both cheilectomy alone and cheilectomy with SCP showed significant improvements in VAS and AOFAS scores.
• Mean VAS improvement was 5.46 for cheilectomy and 5.78 for cheilectomy with SCP.
• Mean AOFAS improvement was 25.6 for cheilectomy and 31.0 for cheilectomy with SCP.

Conclusions:

• Cheilectomy and cheilectomy with SCP provide good short-term outcomes for hallux rigidus.
• Cheilectomy is a viable joint-preserving surgical option for HR, even in higher grades.
• Subchondroplasty warrants further investigation as an adjunct procedure for surgical hallux rigidus treatment.