Intermediate-term results of isolated minimally invasive arthroscopic cheilectomy in the treatment of hallux rigidus
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ORIGINAL ARTICLE
Intermediate‑term results of isolated minimally invasive arthroscopic cheilectomy in the treatment of hallux rigidus Benjamin A. Hickey1 · Debbie Siew2 · Mithun Nambiar2 · Harvinder S. Bedi1 Received: 2 December 2019 / Accepted: 11 May 2020 © Springer-Verlag France SAS, part of Springer Nature 2020
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. Keywords Minimally invasive · Cheilectomy · Arthroscopy · Metatarsophalangeal joint · Hallux rigidus
Introduction Hallux rigidus causes pain and restricted motion of the hallux first metatarsophalangeal joint (first MTPJ). For early disease without mid-range pain, dorsal cheilectomy can be a good surgical option. Open technique is reported to provide patient satisfaction rates of 70–97% with similarly high success in pain and functional improvement [1–3]. A further surgical procedure is required in approximately 9% of patients within 2 years of initial surgery [4]. Over recent years, minimally invasive techniques using either high torque low speed burr or arthroscopy have been of interest due to the potential for faster recovery [5, 6]. However, * Mithun Nambiar [email protected] 1
OrthoSport Victoria, Level 5, 89 Bridge Road, Richmond, VIC 3121, Australia
Faculty of Medicine, Nursing and Health Sciences, Monash University, Wellington Rd, Clayton, VIC 3800, Australia
2
the intermediate-term outcomes of these techniques are not known. Our aim was to evaluate the effectiveness of minimally invasive cheilectomy of the first MTPJ using a combined technique of high-torque, low-speed burr followed by arthroscopy in a series o
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