Novel treatment for hallux rigidus using a temporary metal interpositional device. Issue 6 (August 2020)

• Record Type: Journal Article
• Authors: Sansone, Valerio; Maiorano, Emanuele; Melato, Marco; Martinelli, Nicoló; Pascale, Valerio
• Is Part Of: Foot and ankle surgery. Volume 26:Issue 6(2020)
• Page Start: 630
• Page End: 636
• Publication Date: 2020-08
• Subjects: Hallux rigidus -- Degenerative joint -- Interpositional arthroplasty -- Articular metal spacer -- Joint preserving procedure -- Foot surgery; Foot -- Surgery -- Periodicals; Ankle -- Surgery -- Periodicals; Ankle -- surgery -- Periodicals; Foot -- surgery -- Periodicals; Ankle -- Surgery; Foot -- Surgery; Periodicals; Electronic journals; 617.58
• DOI: 10.1016/j.fas.2019.08.001
• Languages: English
• ISSNs: 1268-7731

Abstract

Highlights: Temporary metal interpositional arthroplasty provided good clinical outcomes. Two minor complications were recorded during the study. No dislocation of the spacer was observed in the short term follow-up. Abstract: Background: The aim of this prospective study is to evaluate the results of a consecutive series of patients suffering from grade II-III hallux rigidus who underwent a mobility preserving surgical technique consisting of resection arthroplasty with implantation of a temporary metal spacer. Methods: Thirty consecutive patients, 18 female and 12 male with a diagnosis of a grade II–III hallux rigidus, not responding to conservative treatment, underwent a minimal resection arthroplasty followed by the implantation of a temporary metal interpositional device by the same surgeon. All spacers were removed after 6 months through a minimal incision under regional anaesthesia. Patients were clinically and radiographically evaluated at 3, 6, 12 months, and 5 years after spacer removal. Results: The clinical AOFAS scores improved already at first follow-up and continued to improve over time with a statistically significant change until the first year. At 3, 6, and 12 months follow-ups, the number of patients with severely limited ROM (i.e. under 30°, that means grade II–III according to Coughlin and Shaurnas classification) significantly decreased. There were only two minor complications, so defined as both of which resolved spontaneously and did not affect the procedure's effectiveness. Conclusions: We observed good to excellent results with the use of this mobility preserving surgical technique for the treatment of symptomatic grades II and III hallux rigidus. The never before published procedure is easy to perform and inexpensive. Level of evidence: Level IV.