Abstract
Research Type:
Level 3 - Retrospective cohort study, Case-control study, Meta-analysis of Level 3 studies
Introduction/Purpose:
Following conservative management, a cheilectomy procedure is a first line surgical treatment for mild to moderate Hallux Rigidus (HR). Literature on MIS cheilectomy indicates promising results with minimal complication rates. This study aims to evaluate clinical outcomes of patients treated for HR with MIS cheilectomy.
Methods:
33 consecutive patients with HR between 2023 and 2024 were treated with MIS cheilectomy and followed for at least one year. Follow-ups were conducted at 6 weeks, 3 months, 6 months, and 1 year. Patient reported outcome measures (PROMs) used were Foot and Ankle Mobility (FAAM), PROMIS, EuroQol and visual analog score (VAS). Patients were categorized into groups based on their preoperative the Coughlin and Shurnas staging criteria for HR. Secondary outcomes analyzed were adverse outcomes such as HR recurrence, malunion, and infection.
Results:
There were 19 females and 11 males, with an average age of 59 ± 9.3 and a mean BMI of 27.3 ± 4.2. Eleven, fourteen, and eight patients were classified as grade 1, grade 2, and grade 3 HR, respectively. Mean EQ-UA score improved from 1.8 ± 0.9 preoperatively to 1.3 ± 0.5 ( < 0.05), postoperatively. EQ-PD improved from 2.9 ± 0.8 to 2.1 ± 0.8 ( < 0.05). FAAM-ADL score improved from 78.8 ± 12.5 to 88.2 ± 13.5 ( < 0.05). PROMIS-GPH improved from 46 ± 10.7 to 52.1 ± 8.2 ( < 0.05). VAS improved from 4.5 ± 2.3 to 2.9 ± 2.5 ( < 0.05). There was 1 complication which included a patient with recurrence of osteoarthritis, resolved with intraarticular corticosteroid injection.
Conclusion:
EQ-UA, EQ-PD, ADL, GPH, and VAS improvements are indicative of meaningful postoperative benefits. However, other PROM subdomains did not achieve significant clinical improvement. Our study suggests that the preoperative severity of HR does not have an effect on patient postoperative outcomes. While the observed improvements underscore the potential of MIS cheilectomy to enhance patient outcomes, our other findings warrant further exploration.