Dorsal Wedge Phalangeal Osteotomy for Grade II-III Hallux Rigidus in Active Adult Patients

Perez-Aznar, Adolfo; Lizaur-Utrilla, Alejandro; Lopez‐Prats, Fernando A.; Gil-Guillén, Vicente

doi:10.1177/1071100714552481

Cited by 6 publications

(7 citation statements)

References 34 publications

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“…Perez-Aznar et al[25] evaluated the results of a Moberg osteotomy alone in 40 patients (42 toes) with Coughlin and Shurnas Grade II and III hallux rigidus. Both AOFAS (51.7 to 88.8) and VAS scores (76.6 to 1.9) improved significantly from pre-op to post-op.…”

Section: Cheilectomy With Moberg Osteotomymentioning

confidence: 99%

Hallux rigidus: How do I approach it?

Lam¹,

Chan²,

Surace³

et al. 2017

WJO

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Hallux rigidus is a degenerative disease of the first metatarsalphalangeal (MTP) joint and affects 2.5% of people over age 50. Dorsal osteophytes and narrowed joint space leads to debilitating pain and limited range of motion. Altered gait mechanics often ensued as 119% of the body force transmit through the 1st MTP joint during gait cycle. Precise etiology remains under debate with trauma being often cited in the literature. Hallux valgus interphalangeus, female gender, inflammatory and metabolic conditions have all been identified as associative factors. Clinical symptoms, physical exam and radiographic evidence are important in assessing and grading the disease. Non-operative managements including nonsteroidal antiinflammatory drugs, intra-articular injections, shoe modification, activity modification and physical therapy, should always be attempted for all hallux rigidus patients. The goal of surgery is to relieve pain, maintain stability of the first MTP joint, and improve function and quality of life. Operative treatments can be divided into joint-sparing vs joint-sacrificing. Cheilectomy and moberg osteotomy are examples of joint-sparing techniques that have demonstrated great success in early stages of hallux rigidus. Arthrodesis is a joint-sacrificing procedure that has been the gold standard for advanced hallux rigidus. Other newer procedures such as implant arthroplasty, interpositional arthroplasty and arthroscopy, have demonstrated promising early patient outcomes. However, future studies are still needed to validate its long-term efficacy and safety. The choice of procedure should be based on the condition of the joint, patient’s goal and expectations, and surgeon’s experience with the technique.

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Section: Cheilectomy With Moberg Osteotomymentioning

confidence: 99%

Hallux rigidus: How do I approach it?

Lam¹,

Chan²,

Surace³

et al. 2017

WJO

View full text Add to dashboard Cite

show abstract

“…We propose that the Moberg osteotomy changes the first MTPJ configuration when placed under load ( Figure 3A and 3B). Although the Moberg osteotomy is often described as a dorsiflexion osteotomy [21][22][23] (Figure 3A), we found that it changes the configuration of the loaded first MTPJ ( Figure 3B) and shifts the joint contact plantarly (Figure 2). This altered joint configuration likely explains the plantar shift of first MTPJ contact pressure.…”

Section: Discussionmentioning

confidence: 75%

“…Hallux rigidus can be treated surgically with a cheilectomy and Moberg osteotomy. 9,22,23 Although patient outcomes improve following this procedure, the mechanics behind this improvement are unclear. The purpose of this study was to identify the effect of a Moberg osteotomy on loading mechanics at the first MTPJ during simulated stance.…”

Section: Discussionmentioning

confidence: 99%

“…Although cheilectomy has long been used to relieve pain and improve passive range of motion, 18,19 recent studies suggest that supplementing this surgery with a Moberg osteotomy may improve clinical outcomes. 22,23,25 The Moberg osteotomy has been studied in patients with advanced hallux rigidus, showing a reduction in pain and improved range of motion 2 to 4 years after surgery. 22,23 In addition to reduced pain and increased motion, satisfaction rates are as high as 85% for patients with Grade III-IV hallux rigidus 4 years after sugery.…”

Section: Discussionmentioning

confidence: 99%

“…22,23,25 The Moberg osteotomy has been studied in patients with advanced hallux rigidus, showing a reduction in pain and improved range of motion 2 to 4 years after surgery. 22,23 In addition to reduced pain and increased motion, satisfaction rates are as high as 85% for patients with Grade III-IV hallux rigidus 4 years after sugery. 22 Our study demonstrated a small, but potentially clinically meaningful shift in contact pressures that support previously reported clinical data.…”

Section: Discussionmentioning

confidence: 99%

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