BIOPRO resurfacing endoprosthesis versus periarticular osteotomy for hallux rigidus: short-term follow-up and analysis

Abstract

Forty-four patients (47 feet) were enrolled in a prospective hallux rigidus study. A subjective evaluation, physical examination, and radiographic analysis were performed preoperatively and at a 1-year follow-up. Twenty patients (20 feet) underwent a periarticular osteotomy, with 16 patients (16 feet) returning. Seven patients (9 feet) underwent a BIOPRO resurfacing endoprosthesis, with all patients returning. The subjective evaluation was based on a modified American Orthopaedic Foot and Ankle Society Hallux Metatarsophalangeal-Interphalangeal 100-Point scale. The physical examination included first metatarsophalangeal joint range of motion. Radiographic analysis included the metatarsal protrusion distance, transverse plane angulation of the second digit, lateral talo-first metatarsal angle, sagittal plane relationship of the first and second metatarsals, and hallux equinus angle. Statistically significant differences between preoperative and postoperative values were found for the periarticular osteotomy group for the metatarsal protrusion distance ( P = .000), transverse plane angulation of the second digit ( P = .000), and lateral talo-first metatarsal angle ( P = .015). No other statistically significant differences between the pre-operative and post-operative values for either procedure group were found to exist. For this specific patient population the short-term results of surgical intervention for hallux rigidus, whether through a periarticular osteotomy or resurfacing endoprosthesis, provided subjective patient improvement and satisfaction, as well as, minimal increase in first metatarsophalangeal joint range of motion.