First MTP joint arthrodesis for the treatment of hallux rigidus: Results of 29 consecutive cases using the foot health status questionnaire validated measurement tool

Abstract

Background Arthrodesis of the first MTP joint is an accepted and long established joint destructive procedure for the management of hallux rigidus. Objectives This paper presents the results of 29 consecutive first MTP joint arthrodesis procedures for the treatment of hallux rigidus. Method The outcomes of 29 (18 female and 11 male) consecutive arthrodesis procedures were analysed with the Foot Health Status Questionnaire (FHSQ), minimal important difference scores, and a patient satisfaction questionnaire. Results FHSQ foot pain scores improved for 27 (93%) patients; foot function improved for 23 (79%) patients; shoe scores improved for 18 (62%) patients; foot health improved for 20 (68%) patients; general health improved for 12 (41%) patients; physical activity improved for 21 (72%) patients; social capacity improved for 21 (21%) patients; vigour improved for 15 (51%) patients. FHSQ minimal important difference scores were achieved for foot pain in 25 patients (86%); foot function in 17 patients (58%); and general foot health in 19 (65%) patients. Analysis with the matched pairs Wilcoxon rank sum test ( p < 0.05) revealed statistically significant improvement in all FHSQ domains. Female patients appeared to fare better than male patients in all FHSQ categories other than general health and vigour. Conclusion Arthrodesis of the first MTP joint can reliably reduce pain relating to hallux rigidus and can improve foot function and allow a return to physical activity.