Ten-Year Follow-Up of Metatarsal Head Resurfacing Implants for Treatment of Hallux Rigidus

• Published in: The Journal of foot and ankle surgery 2017-09, Vol.56 (5), p.1052-1057
• Main Authors: Hilario, Henry, Garrett, Alan, Motley, Travis, Suzuki, Sumihiro, Carpenter, Brian
• Format: Article
• Language: English
• Subjects: Adult; Aged; arthrodesis; Arthrodesis - methods; Cohort Studies; Female; Follow-Up Studies; hallux limitus; hallux rigidus; Hallux Rigidus - diagnostic imaging; Hallux Rigidus - surgery; Hemiarthroplasty - instrumentation; Hemiarthroplasty - methods; HemiCAP; Humans; Joint Prosthesis; Male; metatarsophalangeal joint; Metatarsophalangeal Joint - diagnostic imaging; Metatarsophalangeal Joint - physiopathology; Metatarsophalangeal Joint - surgery; Middle Aged; Prosthesis Design; Radiography - methods; Range of Motion, Articular - physiology; Retrospective Studies; Risk Assessment; Severity of Illness Index; Time Factors; Treatment Outcome
• ISSN: 1067-2516; 1542-2224
• DOI: 10.1053/j.jfas.2017.05.010

Controversy remains regarding the use of arthroplasty versus arthrodesis in the surgical treatment of late-stage hallux rigidus. The purpose of our retrospective study was to report the long-term follow-up results of the metatarsal head resurfacing implant used for hemiarthroplasty. The patient assessments were conducted using the American Orthopaedic Foot and Ankle Society (AOFAS) metatarsophalangeal clinical rating system and a satisfaction questionnaire. A total of 59 consecutive implantations were performed from January 2005 to December 2009 at our institution. Of the 59 patients, 2 had died and 12 were lost to follow-up, for a 76.3% follow-up rate (45 of 59 procedures) at a mean of 117.67 (range 96 to 143) months. The mean overall AOFAS scale score was 90.6 ± 7.6. The AOFAS pain scale score was 37.78 ± 4.71. One implant was removed, and all remaining patients were happy with their outcome and would repeat the procedure on their other foot, if needed. A subset of patients from a previous mid-term study at our institution showed no significant change in the AOFAS scale scores. Of these 32 patients, 30 (93.75%) were available for follow-up examination at a mean of 122.62 (range 96 to 143) months. We were able to obtain long-term results for 32 implants (30 patients), resulting in a 10-year follow-up rate of 93.7%. With the minimal resection required for this implant, salvage arthrodesis remains a viable option if revision is needed. The surgical treatment of late-stage hallux rigidus with metatarsal head resurfacing allows for low-risk and excellent outcomes at long-term follow-up point.