First metatarsophalangeal joint chondroplasty using the autologous matrix-induced chondrogenesis in treatment of patients with hallux rigidus. Analysis of immediate and medium-term results

Abstract

Introduction. To date, there is no single approach to the surgical treatment of hallux rigidus. In turn, it is known that in the presence of bone-cartilaginous defects in knee, hip and ankle joints, the autologous matrix-induced chondrogenesis is quite successfully used. In this regard, we have proposed to use this technique in patients with hallux rigidus.
 The aim of the study was to evaluate the clinical efficacy of the 1st MTP joint chondroplasty using the induced chondrogenesis technique in patients with HR, to analyze the immediate and medium-term results of the operations in terms of pain and function.
 Materials and methods. The 1st MTP joint chondroplasty has been performed in 21 patients with hallux rigidus. Before the surgery the range of motion (ROM) in 1st MTP joint was measured; the foot condition was evaluated using such scales as VAS of pain, AOFAS, VAS FA. The 1st MTP joint chondroplasty was performed using the technique of the induced chondrogenesis with collagen matrix. The results of surgical treatment were evaluated within 3, 6 and 12 months after surgery.
 Results: 3 months after the operation, a significant decrease in pain, an increase in ROM in 1st MTP joint and an improvement in the foot function were observed. Subsequently, a moderate positive dynamic was observed.
 Conclusion: the results of the operations showed that the 1st MTP joint chondroplasty can be an effective method of surgical treatment, which allows to relieve pain and significantly improve the quality of life of patients with hallux rigidus, both young and elderly. Also, this technique can be used in the treatment of patients with rheumatic diseases of the low activity or remission.