Silastic flexible hinge implant arthroplasty of the great toe for hallux rigidus: A retrospective analysis

10.5580/f52 ◽  
2008 ◽  
Vol 9 (2) ◽  
Keyword(s):  
Retrospective Analysis ◽  
Hallux Rigidus ◽  
Great Toe ◽  
Flexible Hinge

scholarly journals The Use of a Synthetic Cartilage Implant for Hallux Rigidus

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0045
Author(s):  
Niall Smyth ◽  
Jonathan Kaplan ◽  
Amiethab Aiyer
Keyword(s):  
Polyvinyl Alcohol ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Hallux Rigidus ◽  
Reference List ◽  
Great Toe ◽  
Level Of Evidence ◽  
High Level ◽  
Ability Measure

Category: Other Introduction/Purpose: Hallux rigidus is one of the most common pathologies afflicting the foot. Various joint salvage techniques have been described with a multitude of different implants. Recently, a synthetic cartilage implant composed of polyvinyl alcohol (PVA) received FDA premarket approval for treatment of arthritis of the great toe and has been used in over 4,000 cases. The purpose of this study was to systematically review the clinical evidence supporting the use of a PVA implant in hallux rigidus. Methods: A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Using the terms “cartiva OR polyvinyl alcohol OR synthetic cartilage OR hemiarthroplasty AND hallux rigidus OR great toe arthritis OR first toe arthritis “ we searched the PubMed/Medline database in December 2017. In addition, the reference list of publications were scanned for further relevant studies. Results: 4 studies met the inclusion criteria, all of which were derived from a single randomized controlled trial. At short-term follow-up (2 years), patients undergoing placement of a PVA implant had significant improvement in Foot and Ankle Ability Measure (FAAM) sports and activity of daily living, as well as VAS pain scores. The outcomes of the surgery were found to be noninferior compared to arthrodesis. At intermediate follow-up (5 years), the improvement in clinical outcomes persisted and implant survivorship was 96%. Conclusion: There are limited studies available detailing the outcomes of a PVA implant for hallux rigidus, however the results that are available demonstrate a high level of evidence. There are no long-term publications assessing the outcomes of a PVA implant for hallux rigidus.

A Retrospective Analysis of 772 Patients with Hallux Limitus

2002 ◽  
Vol 92 (2) ◽  
pp. 102-108 ◽  
Author(s):  
John F. Grady ◽  
Timothy M. Axe ◽  
Emil J. Zager ◽  
Lori A. Sheldon
Keyword(s):  
Retrospective Analysis ◽  
Surgical Procedures ◽  
Conservative Management ◽  
Hallux Rigidus ◽  
Activity Levels ◽  
Conservative Care ◽  
Hallux Limitus ◽  
Surgical Treatments ◽  
Corticosteroid Injections ◽  
Expected Outcomes

In this retrospective analysis of 772 patients with symptomatic hallux limitus, 428 patients (55%) were successfully treated with conservative care alone; of these 428 patients, 362 (84%) were treated with orthoses. Corticosteroid injections and a change in shoes allowed 24 patients (6% of conservatively treated patients) and 42 patients (10%), respectively, to have less discomfort and return to previous activity levels. Overall, 47% of the patients in this analysis were successfully treated with orthoses. Surgical procedures were performed on 296 patients (38% of all patients) who did not respond to conservative care. In this analysis, 48 of the patients (6% of all patients) who did not respond to conservative care either refused surgery or were not surgical candidates. These data are intended to provide podiatric physicians with expected outcomes for conservative care of hallux limitus. The etiology, symptoms, conservative management, and surgical treatments of hallux limitus and hallux rigidus are also reviewed. (J Am Podiatr Med Assoc 92(2): 102-108, 2002)

scholarly journals Therapeutic Management of the Hallux Rigidus

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Anoop Aggarwal ◽  
Suraj Kumar ◽  
Ratnesh Kumar
Keyword(s):  
Manual Therapy ◽  
Intervention Program ◽  
Hallux Rigidus ◽  
Therapeutic Management ◽  
Great Toe ◽  
Ovid Medline ◽  
Published Evidence ◽  
Cochrane Database ◽  
Comprehensive Intervention

Background. Hallux rigidus is a chronic, disabling condition of foot characterized by reduced great toe extension. The manual therapy approaches are described theoretically however their practical published evidence has not been analyzed well.Objective. Aim of the present paper was to systematically review the literature available for therapeutic management of the hallux rigidus by identifying and evaluating the randomized controlled trials (RCTs) and non-RCTs.Methods. To view the hallux rigidus and its rehabilitation, a webbased published literature search of Pubmed, Ovid Medline, Science direct, Cochrane Database, PEDro database, CINAHL was conducted for last 35 years in August 2010 using 4 specific keywords “hallux rigidus, physical therapy, chiropractic, and manual therapy” typed in exactly same manner in the search column of the databases.Result. the review finds that there is acute need of the quality studies and RCTs for the manual therapy, chiropractic, or physiotherapeutic management of the hallux rigidus.Conclusion. Review conclude that conservative programs for hallux rigidus consists of comprehensive intervention program that includes great toe mobilization, toe flexor strengthening, sesamoid bones mobilization and long MTP joint. The clinician should put an emphasis on the mobilization program with proper follow up along with comparative studies for rehabilitation of hallux rigidus.

Therapy of osteoarthritis of the great toe and hallux rigidus

JAMA ◽  
1971 ◽  
Vol 217 (2) ◽  
pp. 215b-215
Author(s):  
M. D. Steinberg
Keyword(s):  
Hallux Rigidus ◽  
Great Toe

Risk Analysis of Nonunion After First Metatarsophalangeal Joint Arthrodesis

2020 ◽  
pp. 193864001989982
Author(s):  
Carla Weber ◽  
Daiwei Yao ◽  
Michael Schwarze ◽  
Karolina Andersson ◽  
Vlatka Andric ◽  
...  
Keyword(s):  
Metatarsophalangeal Joint ◽  
Patient Characteristics ◽  
Hallux Rigidus ◽  
Male Gender ◽  
Great Toe ◽  
Therapeutic Level ◽  
Data Set ◽  
First Metatarsophalangeal Joint ◽  
Factors Influencing ◽  
Radiological Data

Objective: The standard therapy for a symptomatic hallux rigidus is still the arthrodesis of the first metatarsophalangeal (MTP) joint. A nonunion of the arthrodesis is a possible postoperative complication. This study aimed to evaluate the incidence of nonunion associated with first MTP joint arthrodesis and identify risk factors influencing this. Methods: This retrospective study included 197 patients who were treated with an isolated first MTP joint arthrodesis. The severity of MTP-related osteoarthritis was assessed clinically and radiologically prior to surgery according to the Waizy classification. Patient characteristics and radiological parameters were evaluated postoperatively. Results: A full clinical and radiological data set was collected from 153 out of 197 patients. We identified 14 cases of nonunion and found that nonunion was associated with higher incidence of male gender (P = .29), comorbidity (P = .035), higher grade of osteoarthritis (P = .01), and increased postoperative great toe dorsiflexion (P = .022). Conclusions: Arthrodesis of the first MTP joint is a safe operative treatment, as demonstrated by a nonunion rate of 9.2%. Negative influencing factors were the presence of preexisting diseases, higher grades of osteoarthritis, and a relative increased dorsiflexion position of the great toe after surgery. These factors should be considered during pre-, intra-, and postoperative planning. Levels of Evidence: Therapeutic, Level IV: Retrospective

Gait Analysis of the Donor Foot in Microsurgical Reconstruction of the Thumb

1995 ◽  
Vol 16 (4) ◽  
pp. 201-206 ◽  
Author(s):  
Francesco Barca ◽  
Alessandro Santi ◽  
Pier Luigi Tartoni ◽  
Antonio Landi
Keyword(s):  
Donor Site ◽  
Hallux Rigidus ◽  
Metatarsal Bone ◽  
Wilcoxon Test ◽  
Great Toe ◽  
Microsurgical Reconstruction ◽  
The Third ◽  
Metatarsal Bones ◽  
Toe Transfer ◽  
Second Toe

Clinical and step evaluations by a piezoelectric system board were performed in 54 patients who underwent microsurgical reconstruction of the thumb by great or second toe transfer. Forty-four patients were male and 10 were female. In 13 cases, the thumb was reconstructed by the Morrison wrap-around technique. In 27 cases, an extended variant of the Morrison technique was used in which the whole distal phalanx was harvested with skin and nail apparatus. Four patients were treated by great toe transfer and 10 were treated by second toe transfer. Follow-up ranged from 2 to 144 months. The group of patients treated by the wrap-around technique presented hallux rigidus in 38.5% of cases. The group of patients treated by the extended variant of the Morrison technique presented a lesser tendency to hallux rigidus but a clear reduction of the pushing phase of hallux. The group of patients treated by second toe transfer presented a third and fourth metatarsal bone overload that was confirmed by a statistical Wilcoxon test: overload was linked to a plantar hyperkeratosis at the third metatarsal (20%), fourth metatarsal (10%), or fifth metatarsal bone (20%). A claw deformity of the third and fourth toes was observed in 20% of these patients. The four patients who underwent microsurgical reconstruction of the thumb by great toe transfer exhibited an overload of central and lateral metatarsal bones. Second toe transfer is not associated with the functional or cosmetic changes seen in great toe transfer and is therefore preferred. The cosmetic and functional results from extended great toe transfer make this a much less desirable transfer than the wrap-around or modified wrap-around technique. The transfer with the least donor site problem is second toe to thumb.

Silastic Ball Spacer Arthroplasty in the Management of Hallux Valgus and Hallux Rigidus

Foot & Ankle ◽  
1989 ◽  
Vol 10 (2) ◽  
pp. 61-64 ◽  
Author(s):  
N. S. Broughton ◽  
A. Doran ◽  
B. F. Meggitt
Keyword(s):  
Hallux Valgus ◽  
Young Patients ◽  
Metatarsophalangeal Joint ◽  
Hallux Rigidus ◽  
New Bone Formation ◽  
Great Toe ◽  
First Metatarsophalangeal Joint ◽  
Proximal Migration ◽  
Original Concept

Sixty-two feet in 39 patients who were treated by insertion of a silastic ball spacer prosthesis into the first metatarsophalangeal joint for hallux valgus or hallux rigidus have been reviewed with a follow-up time of between 2 and 6 years. Twenty-one results (34%) were excellent, 27 (43%) were fair, 13 (21%) were poor, and one was revised. Seventeen feet (27%) had some metatarsalgia at followup. Results were disappointing in the young patients; in 19 cases of hallux valgus under the age of 45, 8 were either poor or had been revised. The original concept of the silastic ball spacer was to maintain great toe length and prevent proximal migration of the sesamoids. However 60% of these feet showed settling of the prosthesis or new bone formation around the prosthesis and 54% had more than 2 mm proximal migration of the sesamoid bones. The symptomatic results in these patients were similar to those in whom great toe length had been successfully maintained. The silastic ball spacer infrequently achieves its aims, however maintenance of hallux length does not seem to be important in the symptomatic result.

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