Esser K, Butler JJ, Roof M, Mercer NP, Harrington MC, Samsonov AP, Rosenbaum AJ, Kennedy JG. Outcomes following minimally invasive dorsal cheilectomy for hallux rigidus: A systematic review. World J Orthop 2024; 15(6): 585-592 [PMID: 38947256 DOI: 10.5312/wjo.v15.i6.585]
Corresponding Author of This Article
John G Kennedy, FRCS, MCh, MD, MSc, Professor, Department of Orthopedic Surgery, NYU Langone Health, 171 Delancey Street, New York, NY 10002, United States. john.kennedy@nyulangone.org
Research Domain of This Article
Orthopedics
Article-Type of This Article
Systematic Reviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Jun 18, 2024; 15(6): 585-592 Published online Jun 18, 2024. doi: 10.5312/wjo.v15.i6.585
Outcomes following minimally invasive dorsal cheilectomy for hallux rigidus: A systematic review
Katherine Esser, James J Butler, Mackenzie Roof, Nathaniel P Mercer, Michael C Harrington, Alan P Samsonov, Andrew J Rosenbaum, John G Kennedy
Katherine Esser, Department of Orthopaedic Surgery University of Toledo Medical Center, University of Toledo College of Medicine and Life Sciences, Toledo, OH 43614, United States
James J Butler, Mackenzie Roof, Nathaniel P Mercer, Alan P Samsonov, John G Kennedy, Department of Orthopedic Surgery, NYU Langone Health, New York, NY 10002, United States
Michael C Harrington, Andrew J Rosenbaum, Department of Orthopedic Surgery, Albany Medical Center, Albany, NY 12208, United States
Co-first authors: Katherine Esser and James J Butler.
Author contributions: Esser K and Butler JJ contributed equally to this work; Esser K, Butler JJ, Roof M, Rosenbaum AJ and Kennedy JG designed the research study; Esser K, Samsonov AP and Harrington MC extracted the data; Butler JJ and Mercer NP analysed the data; Esser K wrote the first draft of the manuscript; Butler JJ, Rosenbaum AJ and Kennedy JG edited the manuscript; Roof M and Harrington MC created the tables, Samsonov AP created the figures; All authors have read and approve the final manuscript.
Conflict-of-interest statement: No direct funding was provided for this study. John G Kennedy has the following conflicts of interests: John G Kennedy is a consultant for Arthrex and In2Bones. There are donors who contribute to Dr. Kennedy’s discretionary research pool, which is utilised for other studies (not utilised in this study). John G Kennedy receives financial support from the Ohnell Family Foundation, Mr. Winston Fisher and Ms. Tatiana Rybak. No other author has any conflicts of interests to disclose.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/.
Corresponding author: John G Kennedy, FRCS, MCh, MD, MSc, Professor, Department of Orthopedic Surgery, NYU Langone Health, 171 Delancey Street, New York, NY 10002, United States. john.kennedy@nyulangone.org
Received: January 17, 2024 Revised: March 10, 2024 Accepted: May 7, 2024 Published online: June 18, 2024 Processing time: 147 Days and 11.7 Hours
Abstract
BACKGROUND
Cheilectomy of the 1st metatarsophalangeal joint (MTPJ) is one of the most common procedures for the management of hallux rigidus. However, there is no consensus regarding outcomes following minimally invasive dorsal cheilectomy (MIDC) for the management of hallux rigidus.
AIM
To evaluate outcomes following MIDC for the management of hallux rigidus.
METHODS
During November 2023, the PubMed, EMBASE and Cochrane Library databases were systematically reviewed to identify clinical studies examining outcomes following MIDC for the management of hallux rigidus.
RESULTS
Six studies were included. In total, 348 patients (370 feet) underwent MIDC for hallux rigidus at a weighted mean follow-up of 37.9 ± 16.5 months. The distribution of patients by Coughlin and Shurna's classification was recorded in 4 studies as follows: I (58 patients, 27.1%), II (112 patients, 52.3%), III (44 patients, 20.6%). Three studies performed an additional 1st MTPJ arthroscopy and debridement following MIDC. Retained intra-articular bone debris was observed in 100% of patients in 1 study. The weighted mean American orthopedic foot and ankle society score improved from a preoperative score of 68.9 ± 3.2 to a postoperative score of 87.1. The complication rate was 8.4%, the most common of which was persistent joint pain and stiffness. Thirty-two failures (8.7%) were observed. Thirty-three secondary procedures (8.9%) were performed at a weighted mean time of 8.6 ± 3.2 months following the index procedure.
CONCLUSION
This systematic review demonstrated improvements in subjective clinical outcomes together with a moderate complication rate following MIDC for the management of hallux rigidus at short-term follow-up. A moderate re-operation rate at short-term follow-up was recorded. The marked heterogeneity between included studies and paucity of high quality comparative studies limits the generation of any robust conclusions.
Core Tip: This systematic review found improvements in patient reported outcome measurements together with a moderate complication rate following minimally invasive dorsal cheilectomy (MIDC) for the management of hallux rigidus at short-term follow-up. A moderate re-operation rate at short-term follow-up was recorded. The marked heterogeneity between included studies and dearth of high quality comparative studies limits the generation of any robust conclusions. This current systematic review demonstrates that MIDC may be a safe, efficacious procedure in the setting of low-to-moderate grade hallux rigidus.
