Replacement arthroplasty of the first metatarsophalangeal joint using a ceramic-coated endoprosthesis for the treatment of hallux rigidus.

Abstract

We prospectively assessed 40 patients who underwent total first metatarsophalangeal joint replacement arthroplasty using a ceramic implant for the treatment of hallux rigidus. A total of 42 toes in 40 patients were included in the assessment. Preoperatively, the mean American Orthopaedic Foot and Ankle Society (AOFAS) hallux first metatarsal score was 36.00 +/- 10.79 points, and first metatarsophalangeal joint range of motion was 4.9 degrees +/- 5.52 degrees . The mean preoperative AOFAS score increased from 36.00 +/- 10.79 to 82.20 +/- 9.54 at 3 months (P < .001), to 87.00 +/- 10.62 at 12 months, and to 84.20 +/- 10.69 at 24 months. There was no statistically significant change in scores from 3 months onward. Range of motion increased to 70.80 degrees +/- 15.97 degrees in the operating room and reduced to 45.60 degrees +/- 12.28 degrees at 3 months postoperative, decreasing to 40.00 degrees +/- 12.72 degrees at 12 months and 33.30 degrees +/- 17.19 degrees at 24 months postop. We advocate total toe arthroplasty with this all-ceramic press-fit implant as an effective procedure for the treatment of moderate to severe hallux rigidus. This ceramic, total first metatarsophalangeal joint endoprosthesis yields good improvement in foot-related quality-of-life scores, reasonable range of motion, and a low early revision rate.