Functional results of Keller's arthroplasty and its modifications in the treatment of Hallux Rigidus in adults

ABSTRACT

This study was performed to evaluate the functional results of operative treatment of hallux rigidus in adults by Keller's arthroplasty and modified Keller's arthroplasty. Twenty adult patients, fourteen-females [one of them had bilateral hallux rigidus] and five males were presented to the outpatient clinic in the Suez Canal university hospital was included in the study and they had hallux rigidus of the metatarsophalangeal joint of the big toe grade two [thirteen patients] and grade three [seven patients] patients were divided into two groups, group A operated by Keller's arthroplasty and group B by modified Keller's arthoplasty. Follow up with clinical and radiological assessment was done at six and twelve months for both groups. The functional outcome for both groups was evaluated according to Michael et al., Seven patients in group B [70%] and two patients in group A [20%] had excellent results at one year follow up according to the system proposed by Michael et al., also two patients [20%] of group A have poor results. Limited range of motion and poor foot function as a result of recurrence of osteophyte formation and narrowing of the joint space were the causes of poor outcome. Postoperative complications were only superficial infection in two patients in the first group. Keller's arthroplsty is an easier technique but the modified procedure has a better functional result and it is more stable than Keller's arthroplasty