Newer Ideas for Hallux Rigidus (HR)

Outcomes for cheilectomy and osteotomies for HR are generally OK, but not great. Are newer treatment approaches worth the squeeze?

The smaller the incision … not so quick

In a study comparing 73 open cheilectomies to 61 minimally invasive (MIS) cheilectomies, authors found a higher rate of stiffness in the open group, but no difference in complications. Another study compared 71 patients undergoing open cheilectomy with Moberg osteotomy (OCM) to 48 patients undergoing percutaneous cheilectomy, using PROMIS scoring. At one year post-operatively, the open group showed greater improvement in physical function, pain interference, and pain intensity, with no difference in re-operation rate. 

Stem cells do not seem to make a difference in the short term 

In yet another study, authors investigated the use of stem cells as the active variable by comparing short-term patient-reported clinical outcomes and complications between two groups: those undergoing cheilectomy and Moberg osteotomy (CM) and those undergoing the same procedures with the addition of stem cells (CM + BMAC) for HR. Both groups showed significant improvement in physical function, pain interference, pain intensity, and overall physical health. However, there were no significant differences in preoperative or postoperative PROMIS domains between the two groups.