Evaluation of Clinical Outcomes After Cheilectomy and Microfracture in Hallux Rigidus

Öz

Halluks rigidus (HR), birinci metatarsofalangeal eklemi etkileyen ve ağrı, sertlik ile fonksiyonel kısıtlılıklara neden olan yaygın bir osteoartrit formudur. Eklem koruyucu bir cerrahi yöntem olan çelyektomi, erken ve orta evre HR olgularında sıklıkla tercih edilmektedir. Mikrokırık tekniği ise kıkırdak tamirini hedefleyen ve fibrokartilaj oluşumunu uyaran bir yöntemdir. Bu retrospektif çalışmada, Ocak 2019 ile Eylül 2023 tarihleri arasında çelyektomi uygulanan 62 hasta değerlendirildi. Hastalar sadece çelyektomi yapılanlar (Grup 1, n=32) ve çelyektomiye ek mikrokırık uygulananlar (Grup 2, n=30) olarak iki gruba ayrıldı. Ortalama takip süresi Grup 1’de 25,8 ± 7,2 ay (18–40 ay aralığında), Grup 2’de ise 23,1 ± 7,3 ay (16–42 ay aralığında) idi. Fonksiyonel sonuçlar; American Orthopaedic Foot and Ankle Society (AOFAS) skoru, Vizüel Analog Skala (VAS) ağrı skoru ve dorsifleksiyon (DF) açıları kullanılarak değerlendirildi. Her iki grupta postoperatif tüm parametrelerde istatistiksel olarak anlamlı iyileşme izlendi (p<0.001); ancak AOFAS skorları mikrokırık uygulanan grupta anlamlı olarak daha yüksekti (p=0.0168). Gruplar arasında VAS ve DF açısı açısından anlamlı fark saptanmadı. Bulgular, çelyektomiye ek olarak uygulanan mikrokırık tekniğinin kısa ve orta vadede fonksiyonel sonuçları artırabileceğini göstermektedir. Ancak yöntemin uzun dönem etkinliğinin değerlendirilmesi için ileriye dönük çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

• Hallux rigidus
• cheilectomy
• microfracture
• foot surgery

Evaluation of Clinical Outcomes After Cheilectomy and Microfracture in Hallux Rigidus

Öz

Hallux rigidus (HR) is a common form of osteoarthritis that affects the first metatarsophalangeal joint, causing pain, stiffness, and functional limitations. Cheilectomy, a joint-preserving surgical method, is often used in early to mid-stage HR. Microfracture is a cartilage repair technique that stimulates fibrocartilage formation. This retrospective study evaluated and compared the clinical outcomes of 62 patients who underwent cheilectomy alone (Group 1, n=32) or cheilectomy combined with microfracture (Group 2, n=30) between January 2019 and September 2023. The mean follow-up duration was 25.8 ± 7.2 months (range, 18–40 months) in Group 1 and 23.1 ± 7.3 months (range, 16–42 months) in Group 2. Functional outcomes were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) score, Visual Analog Scale (VAS) for pain, and dorsiflexion (DF) angles. Both groups demonstrated statistically significant improvements in all parameters postoperatively (p<0.001), while the AOFAS scores were significantly higher in the combined microfracture group (p=0.0168). No significant differences were observed in VAS and DF angle values between the groups. These findings suggest that the addition of microfracture to cheilectomy may enhance short- to mid-term functional outcomes without increasing complications. Further prospective, long-term studies are required to confirm its sustained effectiveness and potential benefits in the treatment of hallux rigidus.

Anahtar Kelimeler

• Hallux rigidus
• cheilectomy
• microfracture
• foot surgery

Kaynakça

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