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Cheilectomy, Osteotomy, Microfracture, and Matrix-Induced Chondrogenesis (COMM): A Novel Combined Procedure for
Daran Huang1, Wenxian Png1, Inderjeet Singh Rikhraj1
1Department of Orthopaedic Surgery, Sengkang General Hospital, Singapore, Singapore.
Cartilage
|May 22, 2025
Summary
The novel COMM procedure, combining cheilectomy, osteotomy, microfracture, and matrix-induced chondrogenesis, significantly improved pain and function in hallux rigidus patients. This innovative approach shows promising early clinical outcomes and high patient satisfaction for degenerative MTPJ disorder.
Area of Science:
- Orthopedics
- Regenerative Medicine
- Foot and Ankle Surgery
Background:
- Hallux rigidus (HR) is a degenerative joint disorder affecting the first metatarsophalangeal joint (MTPJ), leading to pain and stiffness.
- Current surgical options for HR include cheilectomy, microfracture (MF), and dorsal oblique osteotomy (DOO).
- The novel addition of matrix-induced chondrogenesis (MIC) with bone marrow aspirate concentrate (BMAC) is hypothesized to enhance cartilage healing in HR.
Purpose of the Study:
- To describe the novel COMM procedure, a combination of cheilectomy, dorsal oblique osteotomy (DOO), microfracture (MF), and matrix-induced chondrogenesis (MIC).
- To evaluate the early clinical outcomes and patient satisfaction following the COMM procedure in a series of hallux rigidus cases.
Main Methods:
- A retrospective study of 12 hallux rigidus cases treated with the COMM procedure between May 2022 and June 2023.
- Evaluation of 1-year postoperative outcomes using Numeric Pain Rating (NPR), European Foot and Ankle Society (EFAS) scores, and Short Form-36 (SF-36) scores (Physical Function [SF-PF] and Mental Health [SF-MH]).
- Comparison of pre- and postoperative scores to assess treatment efficacy and patient satisfaction.
Main Results:
- Statistically significant improvements (P < 0.05) were observed across all evaluated scores.
- EFAS scores improved from 9.3 to 20.0 (Foot/Ankle) and 3.8 to 9.4 (Sports).
- SF-PF and SF-MH scores increased from 47.9% to 67.9% and 54.0% to 66.0%, respectively. Mean NPR decreased significantly at rest and during activity.
- Mean postoperative satisfaction was 8.0 out of 10.
Conclusions:
- The COMM procedure demonstrates promising early clinical outcomes for hallux rigidus.
- Significant improvements in pain, function, and patient satisfaction were noted.
- This novel combination technique warrants further investigation for hallux rigidus treatment.
Keywords:
autologouscheilectomychondroplastydistal oblique osteotomyfirst metatarsophalangeal jointhallux rigidusmatrix-induced chondrogenesisosteoarthritisMore Related Videos
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