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Foot & Ankle

Functional outcomes and sporting ability after cheilectomy and first metatarsophalangeal joint arthrodesis for hallux rigidus: a comparative study

British Orthopaedic Foot & Ankle Society (BOFAS) November 2016



Abstract

Background

Cheilectomy and arthrodesis are accepted procedures for symptomatic hallux rigidus. Although good functional outcomes have been reported, there is little data available on post-operative sporting ability for these patients.

Aims

We investigated sporting ability and functional outcomes of two cohorts of patients, the first underwent dorsal cheilectomy and the second arthrodesis.

Methods

Physical and sporting ability was assessed using the Foot & Ankle Ability Measure (FAAM) sports questionnaire. Functional outcomes were assessed using MOXFQ. Radiological assessment was done according to Hattrup and Johnson classification. (HJ)

Results

Group A (cheilectomy) consisted of 38 feet (35 patients) with a mean age of 57.2 (31–84) and mean follow-up 21.4 months (6–43). 21.6% were HJ1, 43.2% HJ2 and 35.1% HJ3. Group B (arthrodesis) consisted of 49 feet (47 patients) with a mean age of 64.1 (41–81) and mean follow-up 18.5 months (5–41). 6.8% were HJ1, 40.9% HJ2 and 52.3% HJ3.

Mean FAAM score for group A was 78.89% (28.1%–100%). Mean FAAM score for group B was 81.55% (28.1%-100%). Mean MOXFQ score for group A was 14.89/64 (0–41). Mean MOXFQ score for group B was 10.43/64 (0–50). Pain, walking/standing and social domains were 29.74 (0–70), 21.8 (0–96.4) and 17.76 (0–68.8) in group A respectively. In group B, it was 14.79 (0–75), 16.54 (0–78.6), and 17.76 (0–100) respectively. FAAM was higher for group B in comparison to group A, but not statistically significant (P=0.425). Mean MOXFQ score was better in group B compared to group A (P< 0.05). Pain domain in particular was better in group B (P< 0.05).

Conclusion

Our results suggest that both cheilectomy and arthrodesis for hallux rigidus result in similar post-operative sporting ability. Arthrodesis is superior to cheilectomy in overall functional outcomes, particularly in the pain domain.