Abstract
Background A number of complications have been associated with Keller resection arthroplasty and arthrodesis of the first metatarsophalangeal joint for hallux rigidus. Salvage may be by arthrodesis (conversion to or revision). However, the optimal alignment is technically difficult to achieve and even if the fusion is successful, the procedure may still result in transfer metatarsalgia. Objective To assess the viability of prosthetic replacement arthroplasty as a salvage procedure for the first metatarsophalangeal joint. Methods Four patients were identified who had undergone prosthetic replacement arthroplasty (one titanium hemiarthroplasty and three Moje prostheses) as a salvage procedure for failed surgery to the first metatarsophalangeal joint. Mean follow-up was 29.3 months (range 15–46). Patients were assessed with the American Foot and Ankle Society (AOFAS) Hallux Metatarsophalangeal–Interphalangeal Score, subjective patient satisfaction and current radiographs. Results All patients who had a Moje press-fit ceramic arthroplasty reported subjective improvement of pain and function and achieved arcs of movement of between 20° and 50°. Mean AOFAS score was 63 (range 57–73). Radiographs revealed lucency around the prostheses in some patients. Conclusions We feel that the Moje arthroplasty as a salvage procedure is a viable alternative to that of arthrodesis, especially if preservation of movement is desired.
Published Version
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