Intermediate-term Results of Isolated Minimally Invasive Arthroscopic Cheilectomy in the Treatment of Hallux Rigidus

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: Arthroscopy; Cheilectomy; Hallux rigidus; Metatarsophalangeal joint; Minimally invasive.