Abstract
Category:
Midfoot/Forefoot; Other
Introduction/Purpose:
Cheilectomy of the 1st metatarsophalangeal joint is one of the most common procedures for the management of hallux rigidus. However, there is no consensus regarding outcomes following minimally invasive dorsal cheilectomy (MIDC) for the management of hallux rigidus. The purpose of this systematic review was to evaluate outcomes following MIDC for the management of hallux rigidus.
Methods: :
During November 2023, the PubMed, Embase and Cochrane library databases were systematically reviewed to identify clinical studies examining outcomes following MIDC for the management of hallux rigidus. In total, 6 studies were included.
Results:
In total, 348 patients (370 feet) underwent MIDC for hallux rigidus at a weighted mean follow-up of 37.9 ± 16.5 months. The distribution of patients by Coughlin and Shurna's classification was as follows: I (58 patients,27.1%), II (112 patients,52.3%), III (44 patients,20.6%). Three studies performed an additional 1st MTPJ arthroscopy and debridement following MIDC. Retained intra-articular bone debris was observed in 100% of patients in 1 study. The weighted mean AOFAS score improved from a preoperative score of 68.9±3.2 to a postoperative score of 87.1. The complication rate was 8.4%, the most common of which was persistent 1st MTPJ pain and stiffness. Thirty-two failures(8.7%) were observed. Thirty-three secondary procedures(8.9%) were performed at a weighted mean time of 8.6±3.2 months following the index procedure.
Conclusion:
This systematic review demonstrated improvements in subjective clinical outcomes together with a moderate complication rate following MIDC for the management of hallux rigidus at short-term follow-up. A moderate re-operation rate at short-term follow-up was recorded. The marked heterogeneity between included studies and paucity of high quality comparative studies limits the generation of any robust conclusions.