Joint-Preserving Surgeries for Hallux Rigidus Based on Etiology: A Review and Commentary

Area of Science:

• Orthopedic Surgery
• Podiatry
• Biomechanical Research

Background:

• Hallux rigidus is a degenerative condition affecting the first metatarsophalangeal (MTP) joint.
• Current surgical approaches may not fully address the proposed etiology of soft tissue tightness.
• Cochrane's 1927 work identified plantar soft tissue shortening as a potential cause of hallux rigidus.

Purpose of the Study:

• To critically review joint-preserving surgeries for hallux rigidus based on etiological factors.
• To evaluate the rationality of current surgical interventions in relation to the condition's cause.
• To explore the potential of arthroscopic approaches for treating hallux rigidus.

Main Methods:

• Literature review summarizing proposed causes of hallux rigidus.
• Analysis of the progression of hallux rigidus from shortened plantar soft tissues.
• Review of joint-preserving surgical techniques concerning etiology and efficacy.

Main Results:

• Cochrane's surgical approach, addressing plantar tissue tightness, yielded good results in a small cohort.
• Current joint-preserving surgeries for hallux rigidus may lack a direct etiological rationale.
• The arthroscopic Cochrane procedure is presented as a potentially effective, etiology-based option.

Conclusions:

• There is a need to re-evaluate current hallux rigidus surgeries for etiological alignment.
• Addressing plantar soft tissue tightness is crucial for effective hallux rigidus treatment.
• The arthroscopic Cochrane procedure warrants further investigation for hallux rigidus management.