Background: Traditionally severe hallux rigidus is treated with arthrodesis. Recently arthroplasty has been used in order to retain motion at the metatarsophalangeal joint.
Aim: To assess the early to mid-term functional and radiological outcomes in patients undergoing first metatarsophalangeal arthroplasty using the Rotoglide implant.
Materials and methods: A prospective review was undertaken to assess functional and radiological outcomes of all patients undergoing an un-cemented three-component first metatarsophalangeal arthroplasty for hallux rigidus. Thirty four implants were performed in 28 patients over a 2-year period. Mean age was 60.5 years (range 45-77 years). Mean follow-up was 27.7 months (range 7-44 months).
Results: Mean AOFAS score improved from 41.2 pre-operatively to 89.1 at final follow-up (47.9; 95% CI=43.6-54.3; p<0.0001). The mean metatarsophalangeal (MTP) range of motion improved from 29.5° pre-operatively to 68.2° post-operatively (38.7; 95% CI=35.1-42.2; p<0.0001). The mean AOFAS pain scores improved from 8.8 preoperatively to 35.0 postoperatively (26.2; 95% CI=22.4-29.9; p<0.0001). Three patients required revision surgery. No radiological complications were observed in any other patients.
Conclusions: This un-cemented prosthesis provides pain relief, while maintaining range of motion of the joint. The authors have observed clinically and statistically significant improvement in functional outcomes, with a low early complication rate and high patient satisfaction levels.
Keywords: Arthroplasty; Case series; Hallux rigidus; Outcomes; Rotoglide.
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