Surgical Treatment of Advanced Hallux Rigidus by Interpositional Arthroplasty

Background: While arthrodesis is the gold-standard for end-stage hallux rigidus, it leads to loss of mobility. The purpose of this paper was to report our clinical results with modified interpositional arthroplasty for the treatment of advanced (Grade III and IV of Coughlin and Shurnas) hallux rigidus. Material and Methods: Twenty-five feet with Grade III and IV hallux rigidus underwent cheilectomy, minimal proximal phalanx resection (modified Keller) and interposition of the dorsal capsule and EHB. Results: At a minimum followup of 15 months, the mean postoperative hallux AOFAS score was 93.6 points with a pain subscore of 36.4 (maximum, 40 points) and functional subscore of 42.5 (maximum, 45 points). Subjectively, patients were completely satisfied with the surgical outcome in 75% of the cases. Conclusion: The modified interpositional arthroplasty was a feasible surgical option to address advanced hallux rigidus in middle aged patients. Level of Evidence: IV, Case Series