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Published in: European Journal of Orthopaedic Surgery & Traumatology 7/2020

01-10-2020 | Arthroscopy | Original Article

Intermediate-term results of isolated minimally invasive arthroscopic cheilectomy in the treatment of hallux rigidus

Authors: Benjamin A. Hickey, Debbie Siew, Mithun Nambiar, Harvinder S. Bedi

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 7/2020

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Abstract

Aim

The aim of this study was to determine the intermediate-term results of minimally invasive cheilectomy of the first MTPJ using a high-torque low-speed burr and arthroscopic debridement.

Methods

A consecutive series of patients who underwent isolated unilateral minimally invasive cheilectomy of the first MTPJ were contacted by telephone. A questionnaire was used to assess patient satisfaction and complications. Patients with less than 2 years of follow-up were excluded.

Results

Thirty-six patients completed the study. Mean patient age at time of surgery was 50.0 years (range 24.5–67.0). Mean follow-up was 4.69 years (range 2.0–7.3). Thirty patients (83%) reported they would recommend the procedure. Mean postoperative improvement in pain was 69% (range 0–100). Twenty-seven (84%) of patients reported either no pain (28%) or mild pain (56%). For patients who reported any pain, the mean pain experienced was rated as 3.4 out of 10 (range 1–9). Twenty-nine (81%) patients reported they could wear a ‘fashionable’ shoe postoperatively. One patient experienced a delayed rupture of the extensor hallucis longus at 6 months postsurgery. One patient underwent further arthroscopic cheilectomy. No patient required conversion to fusion of the first MTPJ.

Conclusion

Minimally invasive cheilectomy of the first MTPJ using high-torque low-speed burr and arthroscopic debridement results in high patient satisfaction with a low rate of complications at intermediate follow-up.
Literature
1.
go back to reference Bussewitz BW, Dyment MM, Hyer CF (2013) Intermediate-term results following first metatarsal cheilectomy. Foot Ankle Spec 6(3):191–195CrossRef Bussewitz BW, Dyment MM, Hyer CF (2013) Intermediate-term results following first metatarsal cheilectomy. Foot Ankle Spec 6(3):191–195CrossRef
2.
go back to reference Coughlin MJ, Shurnas PS (2003) Hallux rigidus. Grading and long-term results of operative treatment. J Bone Joint Surge Am 85(11):2072–2088CrossRef Coughlin MJ, Shurnas PS (2003) Hallux rigidus. Grading and long-term results of operative treatment. J Bone Joint Surge Am 85(11):2072–2088CrossRef
3.
go back to reference Mulier T, Steenwerckx A, Thienpont E, Sioen W, Hoore KD, Peeraer L et al (1999) Results after cheilectomy in athletes with hallux rigidus. Foot Ankle Int 20(4):232–237CrossRef Mulier T, Steenwerckx A, Thienpont E, Sioen W, Hoore KD, Peeraer L et al (1999) Results after cheilectomy in athletes with hallux rigidus. Foot Ankle Int 20(4):232–237CrossRef
4.
go back to reference Roukis TS (2010) The need for surgical revision after isolated cheilectomy for hallux rigidus: a systematic review. J Foot Ankle Surg 49(5):465–470CrossRef Roukis TS (2010) The need for surgical revision after isolated cheilectomy for hallux rigidus: a systematic review. J Foot Ankle Surg 49(5):465–470CrossRef
5.
go back to reference Razik A, Sott AH (2016) Cheilectomy for hallux rigidus. Foot Ankle Clinics 21(3):451–457CrossRef Razik A, Sott AH (2016) Cheilectomy for hallux rigidus. Foot Ankle Clinics 21(3):451–457CrossRef
6.
go back to reference Walter R, Perera A (2015) Open, arthroscopic, and percutaneous cheilectomy for hallux rigidus. Foot Ankle Clin 20(3):421–431CrossRef Walter R, Perera A (2015) Open, arthroscopic, and percutaneous cheilectomy for hallux rigidus. Foot Ankle Clin 20(3):421–431CrossRef
7.
go back to reference Ibrahim T, Beiri A, Azzabi M, Best AJ, Taylor GJ, Menon DK (2007) Reliability and validity of the subjective component of the American Orthopaedic Foot and Ankle Society clinical rating scales. J Foot Ankle Surg 46(2):65–74CrossRef Ibrahim T, Beiri A, Azzabi M, Best AJ, Taylor GJ, Menon DK (2007) Reliability and validity of the subjective component of the American Orthopaedic Foot and Ankle Society clinical rating scales. J Foot Ankle Surg 46(2):65–74CrossRef
8.
go back to reference Kitaoka HB, Alexander IJ, Adelaar RS, Nunley JA, Myerson MS, Sanders M (1994) Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int 15(7):349–353CrossRef Kitaoka HB, Alexander IJ, Adelaar RS, Nunley JA, Myerson MS, Sanders M (1994) Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int 15(7):349–353CrossRef
9.
go back to reference Nicolosi N, Hehemann C, Connors J, Boike A (2015) Long-term follow-up of the cheilectomy for degenerative joint disease of the first metatarsophalangeal joint. J Foot Ankle Surg 54(6):1010–1020CrossRef Nicolosi N, Hehemann C, Connors J, Boike A (2015) Long-term follow-up of the cheilectomy for degenerative joint disease of the first metatarsophalangeal joint. J Foot Ankle Surg 54(6):1010–1020CrossRef
10.
go back to reference Outerbridge RE, Dunlop JA (1975) The problem of chondromalacia patellae. Clin Orthop Relat Res 110:177–196CrossRef Outerbridge RE, Dunlop JA (1975) The problem of chondromalacia patellae. Clin Orthop Relat Res 110:177–196CrossRef
11.
go back to reference Redfern D, Vernois J, Legre BP (2015) Percutaneous surgery of the forefoot. Clin Podiatr Med Surg 32(3):291–332CrossRef Redfern D, Vernois J, Legre BP (2015) Percutaneous surgery of the forefoot. Clin Podiatr Med Surg 32(3):291–332CrossRef
12.
go back to reference Mann RA, Clanton TO (1988) Hallux rigidus: treatment by cheilectomy. J Bone Joint Surg Am 70(3):400–406CrossRef Mann RA, Clanton TO (1988) Hallux rigidus: treatment by cheilectomy. J Bone Joint Surg Am 70(3):400–406CrossRef
13.
go back to reference Iqbal MJ, Chana GS (1998) Arthroscopic cheilectomy for hallux rigidus. Arthrosc J Arthrosc Relat Surg 14(3):307–310CrossRef Iqbal MJ, Chana GS (1998) Arthroscopic cheilectomy for hallux rigidus. Arthrosc J Arthrosc Relat Surg 14(3):307–310CrossRef
14.
go back to reference Stevens R, Bursnall M, Chadwick C, Davies H, Flowers M, Blundell C et al (2020) Comparison of complication and reoperation rates for minimally invasive versus open cheilectomy of the first metatarsophalangeal joint. Foot Ankle Int 41(1):31–36CrossRef Stevens R, Bursnall M, Chadwick C, Davies H, Flowers M, Blundell C et al (2020) Comparison of complication and reoperation rates for minimally invasive versus open cheilectomy of the first metatarsophalangeal joint. Foot Ankle Int 41(1):31–36CrossRef
15.
go back to reference Coughlin MJ, Shurnas PS (2004) Hallux rigidus. J Bone Joint Surg Am 86-A(Suppl 2(Pt 2)):119–130CrossRef Coughlin MJ, Shurnas PS (2004) Hallux rigidus. J Bone Joint Surg Am 86-A(Suppl 2(Pt 2)):119–130CrossRef
16.
17.
go back to reference Cullen B, Stern AL, Weinraub G (2017) Rate of revision after cheilectomy versus decompression osteotomy in early-stage hallux rigidus. J Foot Ankle Surg 56(3):586–588CrossRef Cullen B, Stern AL, Weinraub G (2017) Rate of revision after cheilectomy versus decompression osteotomy in early-stage hallux rigidus. J Foot Ankle Surg 56(3):586–588CrossRef
18.
go back to reference Ahn JH, Choy WS, Lee KW (2012) Arthroscopy of the first metatarsophalangeal joint in 59 consecutive cases. J Foot Ankle Surg 51(2):161–167CrossRef Ahn JH, Choy WS, Lee KW (2012) Arthroscopy of the first metatarsophalangeal joint in 59 consecutive cases. J Foot Ankle Surg 51(2):161–167CrossRef
19.
go back to reference Lin J, Murphy GA (2009) Treatment of hallux rigidus with cheilectomy using a dorsolateral approach. Foot Ankle Int 30(2):115–119CrossRef Lin J, Murphy GA (2009) Treatment of hallux rigidus with cheilectomy using a dorsolateral approach. Foot Ankle Int 30(2):115–119CrossRef
Metadata
Title
Intermediate-term results of isolated minimally invasive arthroscopic cheilectomy in the treatment of hallux rigidus
Authors
Benjamin A. Hickey
Debbie Siew
Mithun Nambiar
Harvinder S. Bedi
Publication date
01-10-2020
Publisher
Springer Paris
Published in
European Journal of Orthopaedic Surgery & Traumatology / Issue 7/2020
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI
https://doi.org/10.1007/s00590-020-02702-6

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