A biological arthroplastic interposition is described for hallux rigidus, in which the rolled plantaris tendon is positioned at the base of the first phalanx. Eleven patients, for a total of 12 feet, underwent surgery using this technique. The average follow-up was 21 months. In all patients, pain and supination gait disappeared. The average metatarsal motion increased 44° in dorsiflexion. The tendon packet seems to be a good biological spacer, because it adapts and models itself to the new joint function.
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