Evaluation of the Clinical-Radiographic Results of Patients Undergoing Arthroscopic Metatarsal- Phalangeal Arthrodesis of the Hallux

Abstract

Category: Arthroscopy; Midfoot/Forefoot Introduction/Purpose: Hallux rigidus is a common pathological condition of the foot, responsible for a great functional limitation. Metatarsophalangeal arthrodesis is an excellent therapeutic alternative for advanced stages of the disease, usually performed using an open technique. Forefoot arthroscopy has been developed in the last decade, with progressive expansion of indications, bringing encouraging results. Our objective is present the clinical-radiographic results of patients undergoing arthroscopic metatarsophalangeal arthrodesis of the hallux, showing the technique and reporting complications. Methods: This study involves a series of 9 patients (10 feet), all with advanced hallux rigidus (Coughlin-Shurnas grades 3 and 4). All patients underwent an arthroscopic procedure through two dorsal portals with small-joint instruments. Outcomes were assessed using the AOFAS functional score and a visual analogue scale of pain. The radiographic parameters of interest were metatarsal-phalangeal angulation in the anteroposterior (pre- and postoperative) and lateral (post-operative) views, as well as ray shortening. Results: All patients evolved with consolidation in radiographic control at 6 weeks postoperatively and showed a marked improvement in functional scores. We observed a reduction in the metatarsophalangeal angle, without shortening of the radius and of the finger. No patient had transfer metatarsalgia or complaints of cosmetic problems. Conclusion: Arthroscopic metatarsophalangeal arthrodesis is a very relevant therapeutic option for managing advanced stages of hallux rigidus, with minimal aggression and providing excellent results, in addition to a low incidence of complications.