Short-Term Results of Surgical Treatment of Patients with Hallux Rigidus
Notice bibliographique
Résumé
PURPOSE OF THE STUDY Hallux rigidus is common and degenerative arthritis of the first metatarsophalangeal joint. The aim of this study was to assess the results of cheilectomy and total joint replacement (TJR) in patients with hallux rigidus. Minimum duration of followup was 18 months. MATERIAL AND METHODS The study included fifty-nine patients who underwent surgery at our Department due to hallux rigidus between January 2013 and December 2014. Thirty-seven patients underwent cheilectomy and twenty-two patients had total joint arthroplasty using METIS®. The outcomes were assessed by comparing preoperative and postoperative ranges of motion, VAS (Visual Analogue Scale), AOFAS-HMI (American Orthopaedic Foot and Ankle Society Hallux Metatarsophalangeal Interphalangeal) and patients' satisfaction with operative treatment. Preoperative and postoperative outcomes were compared for the individual types of surgery using the repeated measures ANOVA. The level of statistical significance was set at p < 0.01. RESULTS The mean age was 47.9 ± 7.0 years in patients who underwent cheilectomy and 62.5 ± 5.5 years in patients after TJR METIS®. There was a significant decrease (p < 0.001) in the VAS pain score and a significant improvement in dorsiflexion, range of movements, AOFAS-HMI scores in both the treatment groups. In both the groups more than 75% of patients reported good or excellent subjective results. DISCUSSION Our results are in agreement with findings of other studies assessing the results of cheilectomy and TJR surgery in patients with hallux rigidus. Direct comparison of the VAS pain score, AOFAS-HMI and ranges of motion across studies is difficult because of variability in the evaluation systems. Cheilectomy is mostly recommended for young active patients with mild osteoarthritis. Moreover, it is also possible to use minimally invasive surgery with early and reliable outcomes. At our Department, we perform cheilectomy also in younger patients with moderate osteoarthritis in order to extend the period of clinically acceptable results and thereby to postpone the TJR indication. TJR (similarly to arthrodesis of the first metatarsophalangeal joint) is a procedure performed in elderly patients with low physical activity and more advanced deformities. CONCLUSIONS Both the reported methods offer reliable and valuable short-term clinical outcomes with relatively low complication rate. Cheilectomy is undoubtedly more appropriate for younger patients with mild or moderate arthritic changes. Although it does not appear to alter the natural progression of the disease process, it provides satisfactory pain relief, motion improvement and overall patient gait comfort for patients in a short-term period. TJR seems to be a better solution for less active older patients to whom it provides a loadable, painless, and moving joint. Key words: hallux rigidus, first metatarsophalangeal joint, cheilectomy, arthroplasty, Metis®, surgical treatment.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,002 | 0,001 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».