Functional outcomes and sporting ability after cheilectomy and first metatarsophalangeal joint arthrodesis for hallux rigidus: a comparative study

E. Poh, N. Vasukutty, A. Pillai

Background: Cheilectomy and arthrodesis are accepted procedures for symptomatic hallux rigidus. Although good functional outcomes have been reported, there is little data available on post-operative sporting ability for these patients.

Aims: We investigated sporting ability and functional outcomes of two cohorts of patients, the first underwent dorsal cheilectomy and the second arthrodesis.

Methods: Physical and sporting ability was assessed using the Foot & Ankle Ability Measure (FAAM) sports questionnaire. Functional outcomes were assessed using MOXFQ. Radiological assessment was done according to Hattrup and Johnson classification. (HJ)

Results: Group A (cheilectomy) consisted of 38 feet (35 patients) with a mean age of 57.2 (31-84) and mean follow-up 21.4 months (6-43). 21.6% were HJ1, 43.2% HJ2 and 35.1% HJ3. Group B (arthrodesis) consisted of 49 feet (47 patients) with a mean age of 64.1 (41-81) and mean follow-up 18.5 months (5-41). 6.8% were HJ1, 40.9% HJ2 and 52.3% HJ3. Mean FAAM score for group A was 78.89% (28.1%-100%). Mean FAAM score for group B was 81.55% (28.1%-100%). Mean MOXFQ score for group A was 14.89/64 (0-41). Mean MOXFQ score for group B was 10.43/64 (0-50). Pain, walking/standing and social domains were 29.74 (0-70), 21.8 (0-96.4) and 17.76 (0-68.8) in group A respectively. In group B, it was 14.79 (0-75), 16.54 (0-78.6), and 17.76 (0-100) respectively. FAAM was higher for group B in comparison to group A, but not statistically significant (P=0.425). Mean MOXFQ score was better in group B compared to group A (P< 0.05). Pain domain in particular was better in group B (P< 0.05).

Conclusion: Our results suggest that both cheilectomy and arthrodesis for hallux rigidus result in similar post-operative sporting ability. Arthrodesis is superior to cheilectomy in overall functional outcomes, particularly in the pain domain.