ORIGINAL ARTICLE   

Minerva Orthopedics 2023 February;74(1):20-7

DOI: 10.23736/S2784-8469.22.04211-0

Copyright © 2022 EDIZIONI MINERVA MEDICA

language: English

Coughlin grade III hallux rigidus: comparison between distal oblique sliding osteotomy and arthrodesis

Gianni CAIZZI ✉, Florianna PALMIOTTO, Flavia RIEFOLI, Filippo SIMONE, Giacomo ZAVATTINI, Guglielmo OTTAVIANI, Giusi GRAZIANO, Michele COVIELLO, Giovanni VICENTI, Biagio MORETTI

Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy

BACKGROUND: Osteoarthritis of the first metatarsophalangeal joint (hallux rigidus) is the most common degenerative joint pathology of the foot and it is characterized by pain, functional limitation, and radiographic degenerative joint disease. This study aimed to compare the clinical outcomes between arthrodesis and distal oblique sliding osteotomy (DOSO) in patients with hallux rigidus grade 3 according to Choughlin and Shurnas Scale. We hypothesized the DOSO superiority on pain reduction and improvement in quality of life.
METHODS: Sixty-six patients (mean age 57.53), with unilateral first metatarsophalangeal joint arthritis, were recruited from January to July 2020 and randomly selected to have arthrodesis or DOSO. Thirty-six patients were treated with arthrodesis and 30 patients with DOSO. A single surgeon performed all surgery. Functional outcomes: The American Orthopedic Foot and Ankle Score (AOFAS) and Visual Analogic Scale (VAS) were assessed before surgery, at 3 months and at 6 months.
RESULTS: The mean age of the recruited patients was 57.53±7.56 years. VAS scores differed significantly between the two groups at 6 months after surgery (P value <0.0001). AOFAS scores, instead, differed significantly before surgery and tend to get closer in subsequent outpatient visit (P value <0.0001).
CONCLUSIONS: In Coughlin grade III hallux rigidus, DOSO is a safe and effective technique with good results in terms of pain and ROM recovery and certainly a less invasive technique than the classic arthrodesis.

KEY WORDS: Hallux; Osteotomy; Arthrodesis