Baseline and 1-Year Follow-Up Data of Patients with End-Stage Hallux Rigidus Treated with an Arthrodesis Reported to Swefoot

Article Sidebar

PDF Download
Published Jun 26, 2023
DOI: https://doi.org/10.18103/mra.v11i6.3929

Downloads

Download data is not yet available.

Submit your own article

Register as an author to reserve your spot in the next issue of the Medical Research Archives.

Author Registration

Join the Society

The European Society of Medicine is more than a professional association. We are a community. Our members work in countries across the globe, yet are united by a common goal: to promote health and health equity, around the world.

Join Europe’s leading medical society and discover the many advantages of membership, including free article publication.

Membership

Main Article Content

M C Cöster
Department of Clinical Sciences Malmö - Orthopedics, Lund University, Lund, Sweden : Department of Clinical surgeries, Uppsala University, Uppsala, Sweden
I Osbeck
Department of Clinical Sciences Lund – Orthopedics, Lund University, Lund, Sweden.
F Montgomery
Department of Clinical Sciences Malmö - Orthopedics, Lund University, Lund, Sweden
M E Cöster-Stoij
Department of Clinical Sciences Malmö - Orthopedics, Lund University, Lund, Sweden

Abstract

Background: Hallux rigidus (HR) affects the first metatarsophalangeal joint and is the most common osteoarthritic condition in the foot. The most used surgical treatment for severe cases of HR is an arthrodesis. The aim of this study is to describe patient characteristics, surgical treatment and the patient-reported outcomes for patients treated with arthrodesis for HR using data from Swefoot, the Swedish quality register for foot and ankle surgery.


Methods: From Swefoot we extracted data on patients who underwent surgery for HR between January 2014 and December 2019. We included 419 patients with end-stage HR, who had not previously been treated surgically for HR on the same side.


The outcome was measured with the Self-reported Foot and Ankle Score (SEFAS) (summary score 0-48) and EuroQol 5 Dimensions (EQ5D) (index 0-1) together with questions regarding appearance, shoe wear and satisfaction. We extracted surgical and patient-reported data preoperatively and 1 year postoperatively.


Results: Our patient-population is predominantly female, around 61 years old, and


slightly overweight. The arthrodeses are most often fixated with screws and most of the patients are allowed to bear weight immediately after surgery. The mean SEFAS score is 22 preoperatively and 38 postoperatively, the corresponding values for EQ5D index are 0.56 and 0.81 which means that the health-related quality of life (HrQoL) improves significantly after surgery.


Conclusion: Patients with severe HR treated with an arthrodesis have reduced pain, improved function and HrQoL according to the patient-reported outcome measures SEFAS and EQ5D. The mean postoperative SEFAS value was close to the mean SEFAS value of the Swedish general population in the same age category. Fixation techniques and postoperative regimen differ among surgeons in the country. This is the first report from Swefoot regarding this patient population.

Keywords: hallux rigidus, arthrodesis, Swefoot, register, PROMs, SEFAS, EQ-5D

Article Details

How to Cite
CÖSTER, M C et al. Baseline and 1-Year Follow-Up Data of Patients with End-Stage Hallux Rigidus Treated with an Arthrodesis Reported to Swefoot. Medical Research Archives, [S.l.], v. 11, n. 6, june 2023. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/3929>. Date accessed: 21 nov. 2024. doi: https://doi.org/10.18103/mra.v11i6.3929.
ABNT APA BibTeX CBE EndNote - EndNote format (Macintosh & Windows) MLA ProCite - RIS format (Macintosh & Windows) RefWorks Reference Manager - RIS format (Windows only) Turabian
Issue
Vol 11 No 6 (2023): June Issue, Vol.11, Issue 6
Section
Research Articles

The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.

 

References

1. Ho B, Baumhauer J. Hallux rigidus. EFORT Open Rev. Jan 2017;2(1):13-20. doi:10.1302/2058-5241.2.160031
2. Roddy E, Thomas MJ, Marshall M, et al. The population prevalence of symptomatic radiographic foot osteoarthritis in community-dwelling older adults: cross-sectional findings from the clinical assessment study of the foot. Ann Rheum Dis. Jan 2015;74(1):156-63. doi:10.1136/annrheumdis-2013-203804
3. Menz HB, Roddy E, Marshall M, et al. Demographic and clinical factors associated with radiographic severity of first metatarsophalangeal joint osteoarthritis: cross-sectional findings from the Clinical Assessment Study of the Foot. Osteoarthritis Cartilage. Jan 2015;23(1):77-82. doi:10.1016/j.joca.2014.10.007
4. Patel J, Swords M. Hallux Rigidus. StatPearls. 2022.
5. Coughlin MJ, Shurnas PS. Hallux rigidus. J Bone Joint Surg Am. Sep 2004;86-A Suppl 1(Pt 2):119-30.
doi:10.2106/00004623-200409001-00003
6. Coughlin MJ, Shurnas PS. Hallux rigidus: demographics, etiology, and radiographic assessment. Foot Ankle Int. Oct 2003;24(10):731-43. doi:10.1177/107110070302401002
7. Beeson P, Phillips C, Corr S, Ribbans W. Classification systems for hallux rigidus: a review of the literature. Foot Ankle Int. Apr 2008;29(4):407-14. doi:10.3113/FAI.2008.0407
8. Howard N, Cowen C, Caplan M, Platt S. Radiological prevalence of degenerative arthritis of the first metatarsophalangeal joint. Foot Ankle Int. Dec 2014;35(12):1277-81. doi:10.1177/1071100714554451
9. Lam A, Chan JJ, Surace MF, Vulcano E. Hallux rigidus: How do I approach it? World J Orthop. May 18 2017;8(5):364-371. doi:10.5312/wjo.v8.i5.364
10. Warganich T, Harris T. Moberg Osteotomy for Hallux Rigidus. Foot Ankle Clin. Sep 2015;20(3):433-50. doi:10.1016/j.fcl.2015.04.006
11. Shariff R, Myerson MS. The Use of Osteotomy in the Management of Hallux Rigidus. Foot Ankle Clin. Sep 2015;20(3):493-502. doi:10.1016/j.fcl.2015.05.001
12. Slullitel G, Lopez V, Calvi JP, D'Ambrosi R, Usuelli FG. Youngswick osteotomy for treatment of moderate hallux rigidus: Thirteen years without arthrodesis. Foot Ankle Surg. Dec 5 2019;doi:10.1016/j.fas.2019.11.008
13. Sidon E, Rogero R, Bell T, et al. Long-term Follow-up of Cheilectomy for Treatment of Hallux Rigidus. Foot Ankle Int. Oct 2019;40(10):1114-1121. doi:10.1177/1071100719859236
14. Rammelt S, Panzner I, Mittlmeier T. Metatarsophalangeal Joint Fusion: Why and How? Foot Ankle Clin. Sep 2015;20(3):465-77. doi:10.1016/j.fcl.2015.04.008
15. Galois L, Hemmer J, Ray V, Sirveaux F. Surgical options for hallux rigidus: state of the art and review of the literature. Eur J Orthop Surg Traumatol. Jan 2020;30(1):57-65. doi:10.1007/s00590-019-02528-x
16. Gerbert J, Moadab A, Rupley KF. Youngswick-Austin procedure: the effect of plantar arm orientation on metatarsal head displacement. J Foot Ankle Surg. Jan-Feb 2001;40(1):8-14. doi:10.1016/s1067-2516(01)80035-1
17. Coster ME, Montgomery F, Coster MC. Patient-reported outcomes of joint-preserving surgery for moderate hallux rigidus: a 1-year follow-up of 296 patients from Swefoot. Acta Orthop. Feb 2021;92(1):109-113. doi:10.1080/17453674.2020.1824762
18. Coster MC, Coster A, Svensson F, Callreus M, Montgomery F. Swefoot - The Swedish national quality register for foot and ankle surgery. Foot Ankle Surg. Dec 2022;28(8):1404-1410. doi:10.1016/j.fas.2022.07.010
19. Brooks R. EuroQol: the current state of play. Health Policy. Jul 1996;37(1):53-72. doi:10.1016/0168-8510(96)00822-6
20. Coster M, Karlsson MK, Nilsson JA, Carlsson A. Validity, reliability, and responsiveness of a self-reported foot and ankle score (SEFAS). Acta Orthop. Apr 2012;83(2):197-203. doi:10.3109/17453674.2012.657579
21. Coster MC, Bremander A, Rosengren BE, Magnusson H, Carlsson A, Karlsson MK. Validity, reliability, and responsiveness of the Self-reported Foot and Ankle Score (SEFAS) in forefoot, hindfoot, and ankle disorders. Acta Orthop. Apr 2014;85(2):187-94. doi:10.3109/17453674.2014.889979
22. Group E. Euroqol - a new facility for the measurement of health-related quality of life. Euroqol Group. Health Policy. 1990;16(3):199-208.
23. Devlin NJ, Brooks R. EQ-5D and the EuroQol Group: Past, Present and Future. Appl Health Econ Health Policy. Apr 2017;15(2):127-137. doi:10.1007/s40258-017-0310-5
24. Coster MC, Rosengren BE, Karlsson MK, Carlsson A. Age- and Gender-Specific Normative Values for the Self-Reported Foot and Ankle Score (SEFAS). Foot Ankle Int. Nov 2018;39(11):1328-1334. doi:10.1177/1071100718788499
25. Coster MC, Nilsdotter A, Brudin L, Bremander A. Minimally important change, measurement error, and responsiveness for the Self-Reported Foot and Ankle Score. Acta Orthop. Jun 2017;88(3):300-304. doi:10.1080/17453674.2017.1293445
26. Johnsen LG, Hellum C, Nygaard OP, et al. Comparison of the SF6D, the EQ5D, and the oswestry disability index in patients with chronic low back pain and degenerative disc disease. Bmc Musculoskel Dis. Apr 26 2013;14 doi:Artn 14810.1186/1471-2474-14-148
27. Paulsen A, Roos EM, Pedersen AB, Overgaard S. Minimal clinically important improvement (MCII) and patient-acceptable symptom state (PASS) in total hip arthroplasty (THA) patients 1 year postoperatively. Acta Orthop. Feb 2014;85(1):39-48. doi:10.3109/17453674.2013.867782
28. Most J, Hoelen TA, Spekenbrink-Spooren A, Schotanus MGM, Boonen B. Defining Clinically Meaningful Thresholds for Patient-Reported Outcomes in Knee Arthroplasty. J Arthroplasty. May 2022;37(5):837-844 e3. doi:10.1016/j.arth.2022.01.092
29. Strand V, Boers M, Idzerda L, et al. It's good to feel better but it's better to feel good and even better to feel good as soon as possible for as long as possible. Response criteria and the importance of change at OMERACT 10. J Rheumatol. Aug 2011;38(8):1720-7. doi:10.3899/jrheum.110392
30. Bauer T, Lortat-Jacob A, Hardy P. First metatarsophalangeal joint percutaneous arthrodesis. Orthop Traumatol Surg Res. Sep 2010;96(5):567-73. doi:10.1016/j.otsr.2010.01.011
31. Ettl V, Radke S, Gaertner M, Walther M. Arthrodesis in the treatment of hallux rigidus. Int Orthop. 2003;27(6):382-5. doi:10.1007/s00264-003-0492-3
32. Drampalos E, Vun SH, Fayyaz I. Intramedullary and intra-osseous arthrodesis of the hallux metatarsophalangeal joint. J Orthop Surg (Hong Kong). Dec 2016;24(3):358-361. doi:10.1177/1602400317
33. Jansson KA, Granath F. Health-related quality of life (EQ-5D) before and after orthopedic surgery. Acta Orthop. Feb 2011;82(1):82-9. doi:10.3109/17453674.2010.548026
34. Abben KW, Sorensen MD, Waverly BJ. Immediate Weightbearing After First Metatarsophalangeal Joint Arthrodesis With Screw and Locking Plate Fixation: A Short-Term Review. J Foot Ankle Surg. Jul-Aug. 2018;57(4):771-775. doi:10.1053/j.jfas.2018.02.011
35. Crowell A, Van JC, Meyr AJ. Early Weight-Bearing After Arthrodesis of the First Metatarsal-Phalangeal Joint: A Systematic Review of the Incidence of Non-Union. J Foot Ankle Surg. Nov-Dec 2018;57(6):1200-1203. doi:10.1053/j.jfas.2018.05.012
36. Kang YS, Bridgen A. First metatarsophalangeal joint arthrodesis/fusion: a systematic review of modern fixation techniques. J Foot Ankle Res. Apr 26 2022;15(1):30. doi:10.1186/s13047-022-00540-9
37. Kannan S, Bennett A, Chong HH, et al. A Multicenter Retrospective Cohort Study of First Metatarsophalangeal Joint Arthrodesis. J Foot Ankle Surg. May-Jun 2021;60(3):436-439. doi:10.1053/j.jfas.2020.05.015
38. Chien C, Alfred T, Freihaut R, Pit S. First Metatarsophalangeal Joint Arthrodesis in Hallux Valgus Versus Hallux Rigidus Using Cup and Cone Preparation Compression Screw and Dorsal Plate Fixation. Cureus. Oct 19 2017;9(10):e1786. doi:10.7759/cureus.1786
39. Cichero MJ, Yates BJ, Joyce ASD, Williamson DM, Walsh TP. Different fixation constructs and the risk of non-union following first metatarsophalangeal joint arthrodesis. Foot Ankle Surg. Oct 2021;27(7):789-792. doi:10.1016/j.fas.2020.10.006
40. Claassen L, Plaass C, Pastor MF, et al. First Metatarsophalangeal Joint Arthrodesis: A Retrospective Comparison of Crossed-screws, Locking and Non-Locking Plate Fixation with Lag Screw. Arch Bone Jt Surg. Jul 2017;5(4):221-225.