Early Term Functional Results of the Three-Component Total Arthroplasty in the Treatment of Hallux Rigidus

Abstract

Aim: Hallux rigidus is a disease characterized by degeneration of the first metatarsophalangeal (MTF-1) joint. The choice of arthroplasty instead of arthrodesis in the surgical treatment of advanced hallux rigidus is still controversial. In this study, we aimed to report the early treatment results of a number of patients who had advanced hallux rigidus and underwent new-generation three-component press-fit total joint arthroplasty. Materials and Methods: The patients were evaluated in terms of degrees of MTF-1 joint dorsiflexion, plantar flexion, and total joint range of motion (ROM), scores of AOFAS, VAS, SF-12 PCS, and satisfaction survey results. The preoperative and postoperative values were analyzed statistically. Radiologically, anteroposterior (AP) and lateral radiographs were taken and examined for loosening, wear, and alignment. Results: Nineteen joints (14 female, 5 male) of 17 patients were included in the study. The mean age was 59 (49–67) years. The mean patient follow-up was 15 (12–22) months. The mean dorsiflexion degree was 12.7° (range 2.1°–22.1°) preoperatively and 30.1° (11.6°–47.3°) postoperatively. The mean plantar flexion degree was 16° (7.8°–24.2°) preoperatively and 9.2° (2.3°–16.5°) postoperatively. The total range of motion (ROM) of the MTF-1 joint improved from a preoperative 28.4° to a postoperative 39.4°. The mean postoperative AOFAS, VAS, and SF-12 PCS scores were calculated as 85.3 (57–96), 1.3 (0–5), and 57.7 (53.7–59.9), respectively. The increase in the patients’ AOFAS and SF-12 PCS scores and the decrease in the VAS scores were found to be statistically significant. Discussion and Conclusion: Advanced MTF-1 joint osteoarthritis is a disease that causes severe pain and loss of motion. The method for a standard surgical treatment is still controversial. It has been reported in the literature that satisfactory results have been achieved in applications of three-component cementless press-fit total prostheses, in contrast to older prosthetic applications that cause serious complications. The pain relief and the increase in AOFAS scores are considered the most successful aspects of the treatment. Based on the information obtained from this study, we think that application of new-generation three-component press-fit total prostheses is an effective method in the treatment of advanced hallux rigidus, and that the early results are satisfactory when it has been applied to appropriate patients.