A multicenter retrospective review of outcomes for arthrodesis, hemi-metallic joint implant, and resectional arthroplasty in the surgical treatment of end-stage hallux rigidus

J Foot Ankle Surg. 2012 Jan-Feb;51(1):50-6. doi: 10.1053/j.jfas.2011.08.009. Epub 2011 Oct 1.


This is a retrospective, multicenter study examining the long-term results for the treatment of end-stage hallux rigidus using 3 different surgical procedures. A total of 158 subjects (105 females and 53 males) were included in the present study. They had undergone 1 of the following surgical procedures: arthrodesis, hemi-implant, or resectional arthroplasty. The long-term results for the subjective assessment of pain, function, and alignment, as well as objective radiographic and physical findings, were examined. The median interval to postoperative follow-up for the 3 procedure groups was 159 weeks. No statistically significant difference was found in age or the number of subjects included in the 3 treatment groups (p = .11 and p = .16, respectively). The body mass index was significantly different statistically among the 3 treatment groups, with the hemi-implant group representing a smaller body mass index compared with the other procedures (p = .007). No statistically significant difference was found in the subjective outcomes among the 3 treatment groups using the American College of Foot and Ankle Surgeons' First Metatarsophalangeal Joint and First Ray Scoring Scale (patient questionnaire) or the modified Hallux Metatarsophalangeal-Interphalangeal Scale of the American Orthopedic Foot and Ankle Society (p = .64 and p = .14, respectively). Furthermore, the correlation coefficient between the 2 subjective scoring scales was 0.78, statistically significant and reflecting a moderate to high correlation (p < .001). The results of the radiographic and clinical evaluation revealed that metatarsalgia was the most common finding for the arthrodesis group (9.8%), bony overgrowth into the joint for the hemi-implant group (28.3%), and floating hallux for the resectional arthroplasty group (30.9%). The results of our study suggest that all 3 surgical procedures are viable options for the treatment of end-stage hallux rigidus.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arthralgia / etiology
  • Arthrodesis*
  • Arthroplasty / methods*
  • Arthroplasty, Replacement*
  • Body Mass Index
  • Female
  • Hallux Rigidus / surgery*
  • Humans
  • Joint Prosthesis*
  • Male
  • Metatarsalgia / etiology
  • Metatarsophalangeal Joint / surgery
  • Middle Aged
  • Postoperative Complications
  • Reoperation / statistics & numerical data
  • Retrospective Studies
  • Severity of Illness Index
  • Treatment Outcome