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Joint Salvage Procedures for Failed First Metatarsal Phalangeal Joint Cheilectomy

Liechti, Daniel J. MD; Backus, Jonathon D. MD; Clanton, Thomas O. MD

Techniques in Foot & Ankle Surgery: September 2016 - Volume 15 - Issue 3 - p 113–118
doi: 10.1097/BTF.0000000000000130
Special Focus: Revision Forefoot Surgery
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Hallux rigidus is a painful arthritic condition of the first metatarsal phalangeal joint. For over 40 years, cheilectomy has been considered a first-line surgical treatment for mild and moderate cases of hallux rigidus. Despite successful results in the majority of cases, cheilectomy sometimes fails. Therefore, a number of revision surgical treatment options are available including joint-salvaging procedures such as repeat cheilectomy, dorsal osteotomy of the proximal phalangeal base, or interposition arthroplasty with allograft tissue. These revision surgical procedures will be discussed along with factors such as patient age, activity level, reason for primary failure, and severity of hallux rigidus that aid in decision-making.

Level of Evidence: Diagnostic Level V. See Instructions for Authors for a complete description of levels of evidence.

The Steadman Clinic, Vail, CO

T.O.C receives royalties for any pharmaceutical, biomaterial, or orthopedic product or device: Arthrex Inc., Stryker, Inc. Within the past 12 months, served on a speakers’ bureau or has been paid an honorarium to present by any pharmaceutical, biomaterial, or orthopedic product or device company: Arthrex Inc., Stryker Inc., Small Bone Innovations, Wright Medical Technology. Paid consultant for any pharmaceutical, biomaterial, or orthopedic device and equipment company, or supplier: Arthrex Inc., Stryker Inc., Small Bone Innovations, Wright Medical Technology. Receive research or institutional support as a principal investigator from any pharmaceutical, biomaterial, orthopedic device and equipment company, or supplier: Arthrex Inc. Receive royalties, financial or material support from publishers: Saunders/Mosby-Elsevier. Board member/committee appointment for a society: American Orthopaedic Foot and Ankle Society. The Steadman Philippon Research Institute has received financial support not related to this study from the following: Arthrex Inc., ConMed Linvatec, Opedix, Ossur Americas, Siemens Medical Solutions USA, Small Bone Innovations, Smith & Nephew Endoscopy, Arthrex Inc. The other authors declare no conflict of interest.

Address correspondence and reprint requests to Thomas O. Clanton, MD, The Steadman Clinic, 181 W. Meadow Drive, Suite 200, Vail, CO 81657. E-mail: tclanton@thesteadmanclinic.com.

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