Physical Function and Pain Interference Levels of Hallux Rigidus Patients Before and After Synthetic Cartilage Implant vs Arthrodesis Surgery.

Abstract

Hallux rigidus is a common and painful degenerative condition of the great toe limiting a patient's physical function and quality of life. The purpose of this study was to investigate pre- and postoperative physical function (PF) and pain interference (PI) levels of patients undergoing synthetic cartilage implant hemiarthroplasty (SCI) vs arthrodesis (AD) for treatment of hallux rigidus using the Patient-Reported Outcomes Measurement Information System (PROMIS). PROMIS PF and PI <i>t</i> scores were analyzed for patients who underwent either SCI or AD. Postoperative final PROMIS <i>t</i> scores were obtained via phone survey. Linear mixed model analysis was used to assess differences in PF and PI at each follow-up point. Final follow-up scores were analyzed using independent sample <i>t</i> tests. Total 181 (59 SCI, 122 AD) operatively managed patients were included for analysis of PROMIS scores. Final phone survey was performed at a minimum of 14 (mean 33, range, 14-59) months postoperatively, with 101 patients (40 SCI, 61 AD) successfully contacted. The mean final follow-up was significantly different for SCI and AD: 27 vs 38 months, respectively (<i>P</i> < .01). The mean age of the SCI cohort was lower than the AD cohort (57.5 vs 61.5 years old, <i>P</i> = .01). Average PF <i>t</i> scores were higher in the SCI cohort at baseline (47.1 and 43.9, respectively, <i>P</i> = .01) and at final follow-up (51.4 vs 45.9, respectively, <i>P</i> < .01). A main effect of superior improvement in PF was noted in the SCI group (+4.3) vs the AD group (+2) across time intervals (<i>P</i> < .01). PI <i>t</i> scores were similar between the 2 procedures across time points. The SCI cohort reported slightly superior PF <i>t</i> scores preoperatively and at most follow-up time points compared with the arthrodesis group. No differences were found for PI or complication rates between the 2 treatment groups during this study time frame. Level IV, case series.