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01-10-2020 | Hallux Valgus | Original Paper

Analysis of the effects of arthrodesis of the hallux metatarsophalangeal joint on gait cycle: results of a GAITRite^® treadmill test

Authors: Alexandre Picouleau, Nathlaie Orsoni, Jeremy Hardy, Christian Mabit, Jean-Louis Charissoux, Pierre-Sylvain Marcheix

Published in: International Orthopaedics | Issue 10/2020

Abstract

Introduction

Approximately 80% of patients are satisfied with the outcome of arthrodesis of the hallux metatarsophalangeal (MTP) joint. The hypothesis of this study was that MTP arthrodesis does not influence the walking cycle. The aim of this study was to evaluate the effect of MTP arthrodesis on gait cycle and to measure the functional outcome of MTP arthrodesis after a minimum of two year follow-up.

Method

This was an observational prospective cohort study performed at a single centre that included 26 patients (32 ft) who underwent unilateral or bilateral MTP arthrodesis during the period 2004–2014. An X-ray assessment based on the American Orthopaedic Foot and Ankle Society score was performed pre-operatively and at the last follow-up (average follow-up duration 8.3 years). The walking cycle was analysed at the final follow-up using a GAITRite^® treadmill test.

Results

Twenty unilateral and six bilateral MTP arthrodeses were included in this study. The average age of the patients was 70 years. No significant difference was found in the walking cycle between the operated and non-operated sides for unilaterally MTP arthrodesis. However, we observed a non-significant increase in the percentage of contact time after MTP arthrodesis (65% on the operated side vs. 63% on the non-operated side). We also observed a significant decrease in the average walking rate, and a decrease in walking speed, in cases of bilateral MTP arthrodesis compared with normal walking cycle data from a laboratory study.

Conclusions

MTP joint arthrodesis does not appear to have any effect on the walking cycle, but reduced patient pain and increased the walking distance. The patients reported satisfaction with the surgical outcomes and would recommend it to a relative with the same pathology.

Jarde O, Chabaille E, Ganry O, Havet E, Vives P (2001) Récidive d’hallux valgus traitée par arthrodèse métatarsophalangienne

Tourne Y, Saragaglia D, Zattara A, Maire JP, Picard F, Montbarbon E, Charbel A (1997) Hallux valgus in the elderly: metatarsophalangeal arthrodesis of the first ray. Foot Ankle Int 18(4):195–198. https://doi.org/10.1177/107110079701800402CrossRefPubMed

Bergin SM, Munteanu SE, Zammit GV, Nikolopoulos N, Menz HB (2012) Impact of first metatarsophalangeal joint osteoarthritis on health-related quality of life. Arthritis Care Res 64(11):1691–1698. https://doi.org/10.1002/acr.21729CrossRef

Donegan RJ, Blume PA (2017) Functional results and patient satisfaction of first metatarsophalangeal joint arthrodesis using dual crossed screw fixation. J Foot Ankle Surg 56(2):291–297. https://doi.org/10.1053/j.jfas.2016.10.021CrossRefPubMed

van Doeselaar DJ, Heesterbeek PJ, Louwerens JW, Swierstra BA (2010) Foot function after fusion of the first metatarsophalangeal joint. Foot Ankle Int 31(8):670–675. https://doi.org/10.3113/FAI.2010.0670CrossRefPubMed

Brewster M (2010) Does total joint replacement or arthrodesis of the first metatarsophalangeal joint yield better functional results? A systematic review of the literature. J Foot Ankle Surg 49(6):546–552. https://doi.org/10.1053/j.jfas.2010.07.003CrossRefPubMed

Gibson JN, Thomson CE (2005) Arthrodesis or total replacement arthroplasty for hallux rigidus: a randomized controlled trial. Foot Ankle Int 26(9):680–690. https://doi.org/10.1177/107110070502600904CrossRefPubMed

Stevens J, Meijer K, Bijnens W, Fuchs MC, van Rhijn LW, Hermus JP, van Hoeve S, Poeze M, Witlox AM (2017) Gait analysis of foot compensation after arthrodesis of the first metatarsophalangeal joint. Foot Ankle Int 38(2):181–191. https://doi.org/10.1177/1071100716674310CrossRefPubMed

DeFrino PF, Brodsky JW, Pollo FE, Crenshaw SJ, Beischer AD (2002) First metatarsophalangeal arthrodesis: a clinical, pedobarographic and gait analysis study. Foot Ankle Int 23(6):496–502. https://doi.org/10.1177/107110070202300605CrossRefPubMed

10.

Brodsky JW, Baum BS, Pollo FE, Mehta H (2007) Prospective gait analysis in patients with first metatarsophalangeal joint arthrodesis for hallux rigidus. Foot Ankle Int 28(2):162–165. https://doi.org/10.3113/FAI.2007.0162CrossRefPubMed

11.

Fitzgerald JA (1969) A review of long-term results of arthrodesis of the first metatarso-phalangeal joint. J Bone Joint Surg (Br) 51(3):488–493CrossRef

12.

Bilney B, Morris M, Webster K (2003) Concurrent related validity of the GAITRite walkway system for quantification of the spatial and temporal parameters of gait. Gait Posture 17(1):68–74CrossRef

13.

Papuga MO, Beck CA, Kates SL, Schwarz EM, Maloney MD (2014) Validation of GAITRite and PROMIS as high-throughput physical function outcome measures following ACL reconstruction. J Orthop Res 32(6):793–801. https://doi.org/10.1002/jor.22591CrossRefPubMedPubMedCentral

14.

Kressig RW, Beauchet O, European GNG (2006) Guidelines for clinical applications of spatio-temporal gait analysis in older adults. Aging Clin Exp Res 18(2):174–176CrossRef

15.

Taylor ME, Delbaere K, Mikolaizak AS, Lord SR, Close JC (2013) Gait parameter risk factors for falls under simple and dual task conditions in cognitively impaired older people. Gait Posture 37(1):126–130. https://doi.org/10.1016/j.gaitpost.2012.06.024CrossRefPubMed

16.

Gouelle A (2014) Use of Functional Ambulation Performance Score as measurement of gait ability: review. J Rehabil Res Dev 51(5):665–674. https://doi.org/10.1682/JRRD.2013.09.0198CrossRefPubMed

17.

Hollman JH, McDade EM, Petersen RC (2011) Normative spatiotemporal gait parameters in older adults. Gait Posture 34(1):111–118. https://doi.org/10.1016/j.gaitpost.2011.03.024CrossRefPubMedPubMedCentral

18.

Ballas R, Edouard P, Philippot R, Farizon F, Delangle F, Peyrot N (2016) Ground-reactive forces after hallux valgus surgery: comparison of Scarf osteotomy and arthrodesis of the first metatarsophalangeal joint. Bone Joint J 98-B(5):641–646. https://doi.org/10.1302/0301-620X.98B5.36406CrossRefPubMed

19.

Brodsky JW, Passmore RN, Pollo FE, Shabat S (2005) Functional outcome of arthrodesis of the first metatarsophalangeal joint using parallel screw fixation. Foot Ankle Int 26(2):140–146. https://doi.org/10.1177/107110070502600205CrossRefPubMed

20.

Goucher NR, Coughlin MJ (2006) Hallux metatarsophalangeal joint arthrodesis using dome-shaped reamers and dorsal plate fixation: a prospective study. Foot Ankle Int 27(11):869–876. https://doi.org/10.1177/107110070602701101CrossRefPubMed

21.

DeSandis B, Pino A, Levine DS, Roberts M, Deland J, O'Malley M, Elliott A (2016) Functional outcomes following first metatarsophalangeal arthrodesis. Foot Ankle Int 37(7):715–721. https://doi.org/10.1177/1071100716642286CrossRefPubMed

22.

Galois L, Girard D, Martinet N, Delagoutte JP, Mainard D (2006) Optoelectronic gait analysis after metatarsophalangeal arthrodesis of the hallux: fifteen cases. Rev Chir Orthop Reparatrice Appar Mot 92(1):52–59CrossRef

23.

Thitiboonsuwan S, Kavolus JJ 2nd, Nunley JA 2nd (2018) Hallux interphalangeal arthrodesis following first metatarsophalangeal arthrodesis. Foot Ankle Int 39(10):1178–1182. https://doi.org/10.1177/1071100718780222CrossRefPubMed

24.

Paredes-Carnero X, Fernandez-Cebrian AM, Villardefrancos-Gil S (2018) Do postoperative hallux angles correlate with outcome in MP1 fusion? Our experience with 71 cases. Foot Ankle Spec:1938640017751186. doi:https://doi.org/10.1177/1938640017751186

25.

Chraim M, Bock P, Alrabai HM, Trnka HJ (2016) Long-term outcome of first metatarsophalangeal joint fusion in the treatment of severe hallux rigidus. Int Orthop 40(11):2401–2408. https://doi.org/10.1007/s00264-016-3277-1CrossRefPubMed

26.

Womack JW, Ishikawa SN (2009) First metatarsophalangeal arthrodesis. Foot Ankle Clin 14(1):43–50. https://doi.org/10.1016/j.fcl.2008.11.008CrossRefPubMed

27.

Buranosky DJ, Taylor DT, Sage RA, Sartori M, Patwardhan A, Phelan M, Lam AT (2001) First metatarsophalangeal joint arthrodesis: quantitative mechanical testing of six-hole dorsal plate versus crossed screw fixation in cadaveric specimens. J Foot Ankle Surg 40(4):208–213CrossRef

28.

Harris E, Moroney P, Tourne Y (2017) Arthrodesis of the first metatarsophalangeal joint-a biomechanical comparison of four fixation techniques. Foot Ankle Surg 23(4):268–274. https://doi.org/10.1016/j.fas.2016.07.005CrossRefPubMed

Title: Analysis of the effects of arthrodesis of the hallux metatarsophalangeal joint on gait cycle: results of a GAITRite® treadmill test
Authors: Alexandre Picouleau
Nathlaie Orsoni
Jeremy Hardy
Christian Mabit
Jean-Louis Charissoux
Pierre-Sylvain Marcheix
Publication date: 01-10-2020
Publisher: Springer Berlin Heidelberg
Keywords: Hallux Valgus
Hallux Valgus
Published in: International Orthopaedics / Issue 10/2020
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-020-04716-5

At a glance: The ONWARDS insulin icodec trials

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Analysis of the effects of arthrodesis of the hallux metatarsophalangeal joint on gait cycle: results of a GAITRite^® treadmill test

Abstract

Introduction

Method

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Method

Results

Conclusions

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