Investigación clínica sobre pie y tobillo

Abstracto

Arthrodesis and Hemiarthroplasty: Treatment of Hallux Rigidus

Malty

Hallux Riddus is a progressive degenerative disease affecting the first metatarsal joint. The purpose of this study was to report our experience with treating patients with RH with two different surgical approaches: arthrodesis and hemiarthroplasty. Twelve patients underwent HR surgery from July 2004 to October 2009. The median age was 58 years. At the time of surgery, the patients had different types of FC, according to the modified Regnauld classification. Outcomes were assessed using the American Orthopedic Foot and Ankle Association's Hallux Metatarsophalangeal- Interphalangeal Scale. Tests were performed after one month and then followed by a mean follow-up of 48 months; IQR 29.3–58.0. In the joint treatment group, we observed a mean improvement of 35.5 points at early follow-up. In the artificial joint replacement group, the mean difference at follow-up was 33 IQR 30.5–33.0; p=0.022. At midterm follow-up, the joint surgery group showed a mean difference of 35 IQR (33.0–35.25) compared with the arthroplasty group with a mean score of 30.5 IQR (28.0– 32.5). Our outcomes are consistent with the current understanding of two surgical techniques for the treatment of RH: Today, arthrodesis is considered the treatment of choice in grades III and IV. Hemiarthroplasty seems to be a promising option. Joint pain management and flexibility are fundamental to preventing recurrence and restoring range of motion in dorsal flexion. This article is a retrospective case series with level 4 evidence.