Comparison of Hallux Rigidus Surgical Treatment Outcomes Between Active Duty and Non–Active Duty Populations

Jones, Marc D.; Sweet, Kerry J.

doi:10.7547/17-037

Cited by 6 publications

(2 citation statements)

References 21 publications

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“…19 Conservative treatment options consist of oral antiinflammatory drugs, intra-articular corticosteroid injections, lifestyle modifications, taping, and footwear adjustment. 18,26 Once conservative treatment fails, various surgical procedures can be considered depending on the extent of joint degeneration. For end-stage osteoarthritis, MTP I arthrodesis is often referred to as the gold standard with reliable clinical and radiologic results.…”

Section: Introductionmentioning

confidence: 99%

Ten-Year Minimum Follow-up Study of First Metatarsophalangeal Joint Fusion in Young vs Old Patients

Scheurer,

Zimmermann,

Fischer

et al. 2023

Foot Ankle Int.

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Background: Painful degenerative joint disease (DJD) of the first metatarsophalangeal joint (MTP I), or hallux rigidus, mainly occurs in later stages of life. For end-stage hallux rigidus, MTP I arthrodesis is considered the gold standard. As young and active patients are affected considerably less frequently, it currently remains unclear, whether they benefit to the same extent. We hypothesized that MTP I arthrodesis in younger patients would lead to an inferior outcome with decreased rates of overall with lower rates of patient postoperative pain and function compared to an older cohort. Methods: All patients aged <50 y ears who underwent MTP I arthrodesis at our institution between 1995 and 2012 were included in this study. This group was then matched and compared with a group of patients aged >60 years. Minimum follow-up was 10 years. Outcome measures were Tegner activity score (TAS), a “Virtual Tegner activity score” (VTAS), the visual analog scale (VAS), and the Foot Function index (FFI). Results: Sixty-one MTP I fusions (n = 28 young, n = 33 old) in 46 patients were included in our study at an average of 14 years after surgery. Younger patients experienced significantly more pain relief as reflected by changes in VAS and FFI Pain subscale scores. No difference in functional outcomes was found with change in the FFI function subscale or in the ability to have desired functional outcomes using the ratio of TAS to VTAS. Revision rate did not differ between the two groups apart from hardware removal, which was significantly more likely in the younger group. Conclusion: In patients below the age of 50 years with end-stage DJD of the first metatarsal joint, MTP I arthrodesis not only yielded highly satisfactory postoperative results at least equal outcome compared to an older cohort of patients aged >60 years at an average 14 years’ follow-up. Based on these findings, we consider first metatarsal joint fusion even for young patients is a valid option to treat end-stage hallux rigidus. Level of Evidence: Level III, a case-control study.

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Section: Introductionmentioning

confidence: 99%

Ten-Year Minimum Follow-up Study of First Metatarsophalangeal Joint Fusion in Young vs Old Patients

Scheurer,

Zimmermann,

Fischer

et al. 2023

Foot Ankle Int.

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show abstract

“…1,9,12 In selecting a treatment modality the clinician should consider the natural history of the disease. 3 A wide variety of operative procedures is available 8,12,13 ; however, nonoperative measures decrease the need for surgery and its associated complications. 3,8 Foot orthoses, shoe modification, physiotherapy, manipulation, and systemic nonsteroidal anti-inflammatory drugs are prescribed to alleviate the symptoms.…”

Section: Introductionmentioning

confidence: 99%

Short-term Efficacy of Ultrasonographic Guidance for Intra-articular Corticosteroid Injection in Hallux Rigidus: A Single-Blind Randomized Controlled Trial

et al. 2021

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Background: Multiple considerations should be taken before standardizing a clinical procedure such as efficacy, safety, or the cost. The aim of this study was to compare the effects of landmark-guided vs ultrasonography-guided intra-articular injection of corticosteroid into the first metatarsophalangeal joint cavity to reduce pain and dysfunction in patients with hallux rigidus. Methods: We carried out a single-blind randomized controlled trial with 2 parallel arms in an outpatient clinic affiliated with a medical university. In total, 50 participants (35 women) with the mean (SD) age of 49.8 (10.3) years were randomly allocated to landmark-guided or ultrasonography-guided groups (each n = 25). Each patient received a single intra-articular injection of 40-mg methylprednisolone plus 1 mL lidocaine into the affected first metatarsophalangeal joint. The primary outcome was joint pain and the secondary outcome was the American Orthopaedic Foot & Ankle Society score. We measured the outcomes at baseline and 2 and 6 weeks after the intervention. Results: Six weeks after the injections, there were no statistically significant differences between the study groups in pain reduction and increase in the American Orthopaedic Foot & Ankle Society scores ( P = .131 and .241, respectively). We did not find any complications for the injections in both groups. There were statistically significant changes within each group in pain and the scores for the landmark ( P < .001, and P = .007), and ultrasonography groups (both P < .001). Conclusion: Landmark guidance is as effective as ultrasonographic guidance for intra-articular injection in patients with hallux rigidus. A single intra-articular injection of 40 mg methylprednisolone plus 1 mL lidocaine is an efficient and safe therapeutic measure for decreasing joint pain and maintaining its function, at least for 6 weeks. Level of Evidence: Level I, high-quality prospective randomized study.

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Osteoarthritis of the 1st Metatarsophalangeal Joint

Ekhtiari

Kishta

2021

Evidence‐Based Orthopedics

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Comparison of Hallux Rigidus Surgical Treatment Outcomes Between Active Duty and Non–Active Duty Populations

Abstract: Background: Our aim in this study was to compare the long-term outcomes of three different surgical procedures for the treatment of hallux rigidus (ie, cheilectomy, decompressive osteotomy, and arthrodesis) between active duty military and non-active duty patients.

Cited by 6 publications

References 21 publications

Ten-Year Minimum Follow-up Study of First Metatarsophalangeal Joint Fusion in Young vs Old Patients

Ten-Year Minimum Follow-up Study of First Metatarsophalangeal Joint Fusion in Young vs Old Patients

Short-term Efficacy of Ultrasonographic Guidance for Intra-articular Corticosteroid Injection in Hallux Rigidus: A Single-Blind Randomized Controlled Trial

Osteoarthritis of the 1st Metatarsophalangeal Joint

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