First Metatarsophalangeal Joint Interpositional Arthroplasty Using a Meniscus Allograft for the Treatment of Advanced Hallux Rigidus

Abstract

Hallux rigidus is a progressive disorder of the first metatarsophalangeal (MTP) joint. The disorder is characterized by a loss of range of motion, degenerative changes, and pain within the joint. In later stages of the disease, the surgical procedure of choice is arthrodesis of the joint. Recently, salvage procedures of the first MTP joint using soft tissue interposition has gained popularity. In this retrospective review of 12 patients (13 total procedures) who had late-stage hallux rigidus, we evaluated the effectiveness of a newly proposed salvage procedure using a cadaver meniscus allograft for interposition. First MTP joint dorsiflexion improved from 15.77° (range, 5° -30°) preoperatively to 47.77° (range, 40° -57°; P < .0001). AOFAS (American Orthopaedic Foot and Ankle Society) scores improved from 52.54 points (range, 35-69 points) preoperatively to 90.01 points (range, 82-95 points; P < .0001), with all patients showing improvement. The mean length of follow-up for this study was 16.46 months (range, 5-26 months) with no complications being recorded. The results show that cadaver meniscus allograft interposition is a viable procedure for end-stage hallux rigidus. Level of evidence: therapeutic, level III: retrospective review.