1. Effect of Prior Cheilectomy on Outcomes of First Metatarsophalangeal Joint Fusion for Treatment of Hallux Rigidus.
- Author
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Rajan, Lavan, Kim, Jaeyoung, An, Tonya, Mizher, Rami, Srikumar, Syian, Fuller, Robert, Zhu, Jiaqi, and Ellis, Scott J.
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SURGICAL complication risk factors ,MENTAL depression risk factors ,INFECTION risk factors ,PREOPERATIVE care ,UNUNITED fractures ,ORTHOPEDIC surgery ,FUNCTIONAL status ,HALLUX rigidus ,HEALTH outcome assessment ,RETROSPECTIVE studies ,POSTOPERATIVE care ,MENTAL health ,HEALTH status indicators ,TREATMENT failure ,COMPARATIVE studies ,METATARSOPHALANGEAL joint ,LONGITUDINAL method ,POSTOPERATIVE pain ,PAIN management ,DISEASE risk factors - Abstract
Background: Patients with hallux rigidus who do not experience significant pain relief after cheilectomy often require a conversion to metatarsophalangeal (MTP) fusion. However, it is unclear whether the previous cheilectomy affects outcomes of the subsequent fusion. The aim of this study was to compare patient-reported outcomes and complications in patients undergoing MTP fusion for hallux rigidus between patients with a history of cheilectomy and those undergoing a fusion as a primary procedure. Methods: This retrospective cohort study included patients who underwent MTP fusion who had preoperative and minimum 1-year postoperative Patient Reported Outcomes Measurement Information System (PROMIS) scores. Patients were divided into a "primary MTP fusion" cohort and a "prior cheilectomy" cohort based on their history of a previous cheilectomy. Preoperative, postoperative, and improvement in PROMIS scores, along with rates of complications including nonunion, infection, interphalangeal (IP) joint pain, and removal of hardware were compared between groups. Results: The prior cheilectomy group had significantly lower preoperative physical function scores than the primary MTP fusion group (P <.05). Postoperatively, the prior cheilectomy group had worse physical function (P <.017) and global physical health (P <.017) scores. However, there were no significant differences in pre- to postoperative change in PROMIS scores. There were no significant differences in rates of nonunion (P =.99), infection (P =.99), or hardware removal (P =.99). More patients in the prior cheilectomy group had IP joint pain (P =.034). Conclusion: This study found that a prior cheilectomy may not affect serious complication rates of a subsequent fusion, but it may be associated with worse baseline function. Overall, our results suggest that a prior failed cheilectomy does not influence the amount of improvement in function and pain from MTP fusion. Level of Evidence: Level III, retrospective cohort study. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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