Comparing the Clinical Outcomes of Percutaneous Cheilectomy to Open Cheilectomy With Moberg Osteotomy for the Treatment of Hallux Rigidus.

Background: Both an open cheilectomy with a Moberg osteotomy and percutaneous cheilectomy have been successfully used to treat hallux rigidus and preserve motion.However, there have been no studies that have compared these 2 procedures using validated patient-reported outcomes such as the Patient Reported Outcome Measurement Information System. Methods: A retrospective review of hallux rigidus patients between January 2016 and July 2021 collected 48 percutaneous cheilectomy (PC) patients and 71 open cheilectomy with Moberg (OCM) patients. Preoperative and minimum 1-year postoperative PROMIS scores were collected. Results: The OCM and PC cohorts did not have significant differences in their postoperative PROMIS scores. Both cohorts had modest but significant improvements postoperatively in the physical function, pain interference, and pain intensity domains. The OCM group had a larger degree of improvement in physical function, pain interference, and pain intensity (P = .015, .011, .001, respectively). No significant difference was identified in the reoperation rate. Conclusion: Patients undergoing an OCM had worse preoperative PROMIS scores and a modestly greater change in patient-reported outcomes than patients undergoing a PC. Level of Evidence: Level III, retrospective review.

High Preoperative Pain Score is a Predictor of Cheilectomy Failure in Hallux Rigidus.

Hallux rigidus (HR) is a prevalent arthritic condition in the foot. Cheilectomy is a common joint-preserving procedure for HR, involving the removal of prominent osteophytes to relieve impingement of the 1st MTPJ. This study aims to identify factors associated with the failure of cheilectomy in the treatment of HR. A retrospective review of a prospectively collected database from 2007 to 2021 identified all cheilectomy cases. The minimum follow-up was 2 years. Preoperative demographic data, patient-reported outcome measures (PROMs) and foot radiographs were collected. PROMs were reassessed in postoperative reviews, and cases were categorized as successes or failures. Failure was defined by meeting at least one of the following criteria at the latest review: 1) Visual analog pain score (VAS) more than or equal to 4, 2) undergoing subsequent revision procedures, or 3) reporting poor or terrible satisfaction with the surgery. The analysis involved 66 patients, with 19 failure and 47 success cases. Both groups showed similar age, BMI, and gender profiles. Preoperative radiographic parameters were comparable between groups. However, preoperative VAS was significantly higher in the failure group: 7.16 vs 5.23 (p = .0029). Logistic regression confirmed preoperative VAS as a predictor of nonresponse (p = .023). Receiver Operating Characteristic analysis established an optimal cut-off VAS score of 7.0. Patients with a preoperative VAS score of more than 7 had an odds ratio of 5.11 (p = .0055) for failure. A higher preoperative VAS score is significantly associated with cheilectomy failure in HR treatment, suggesting a cutoff score of 7.0.

Moberg and Moberg-Akin ('Mo-Akin') Osteotomies for Hallux Rigidus.

Hallux rigidus represents the arthritis affecting the first metatarsophalangeal joint. It often leads to limited dorsiflexion, affecting gait and causing pain. Moberg osteotomy involves a dorsal closing wedge osteotomy on the proximal phalanx performed for early stages of hallux rigidus. This osteotomy shifts the load to the plantar aspect and compensates for the limited dorsiflexion. Moberg osteotomy can be combined with Akin osteotomy to create a biplanar correction for hallux interphalangeus. The procedure has favorable outcomes and high patient satisfaction rates with low complications. Larger high-quality studies are required to draw further on its benefits.

Interpositional Arthroplasty for Hallux Rigidus: Surgical Technique and Outcomes Discussion.

Interpositional arthroplasty for the treatment of hallux rigidus (HR) involves resection of the diseased joint surface and placement of spacer material within the joint to preserve length at the metatarsophalangeal joint while still allowing for range of motion. The majority of studies available in the literature have focused on capsular interpositional arthroplasty, revealing generally positive outcomes. Other forms of interpositional arthroplasty are less supported by long-term follow-up and large sample sizes. Moreover, there exists substantial heterogeneity in the studies evaluating interpositional arthroplasty. Despite the limitations of the current data, interpositional arthroplasty seems to be a viable treatment option for HR.

Managing Hallux Rigidus in the Elite Athlete.

Hallux rigidus can present a difficult problem to both competitive and elite athletic populations. Once an appropriate diagnostic workup has been performed, nonoperative management strategies, including anti-inflammatory medications, injection therapies, shoewear modifications, and orthotic devices, represent the mainstay conservative management options. Surgical management can be considered where an athlete's athletic performance is limited. A joint-sparing cheilectomy can provide a predictable return to sport at the most elite levels. The addition of a proximal phalangeal osteotomy can be considered when necessary. Arthroplasty or arthrodesis techniques can be used for persistent symptoms or progressive disease, but with less predictable outcomes.

Minimally Invasive Cheilectomy for Hallux Rigidus.

Hallux metatarsophalangeal joint cheilectomy is a joint-sparing technique that involves resection of the dorsal metatarsal head osteophytes; this may be achieved through minimally invasive and arthroscopic techniques. General indications for minimally invasive surgery (MIS) cheilectomy are mild-to-moderate hallux rigidus (Grades I-II) with symptomatic dorsal osteophytes causing dorsal impingement and/or shoe wear irritation in those who have failed extensive nonoperative management. The literature confirms equivalent outcomes to open cheilectomy; however, it is somewhat inconsistent regarding superiority. The theoretic benefits of MIS cheilectomy include better cosmesis, reduced wound complications, less soft tissue disruption, and faster recovery.

Dorsal Cheilectomy.

Dorsal cheilectomy refers to a surgical resection of the dorsal osteophyte from the first metatarsal head. It is most often performed in patients with hallux rigidus, who have little to no midrange pain of the first metatarsophalangeal joint. The procedure is simple, quick, and maintains range of motion. Additional advantages of this procedure include low morbidity, quicker postoperative recovery, avoidance of costly implants, and the fact that the procedure does not inhibit future conversion to an arthrodesis. These proposed advantages have led some authors to advocate for the use of a cheilectomy, even in patients with more extensive disease.

Effect of Prior Cheilectomy on Outcomes of First Metatarsophalangeal Joint Fusion.

Cheilectomy, a joint-conserving procedure, is often a first-line choice for treating early stages of hallux rigidus. Recent evidence has revealed its efficacy in treating more advanced stages. However, when degeneration is profound, first metatarsophalangeal (MTP) fusion remains the most appropriate strategy. Nevertheless, it is common for surgeons to proceed initially with cheilectomy, reserving joint fusion for subsequent considerations if cheilectomy fails. This article will explore the relationship between the 2 procedures and evaluate the research surrounding the effect of prior cheilectomy on first MTP joint arthrodesis.

Metatarsophalangeal Arthroplasty in Hallux Rigidus.

First metatarsophalangeal joint (MTPJ) arthroplasty provides hallux rigidus patients with pain relief and preserved motion, offering an alternative to arthrodesis. Recent advancements in implant technology and surgical techniques have broadened treatment options. Although good outcomes have been documented in the literature, concerns persist regarding increased complications, uncertain long-term efficacy, and challenges in managing failed arthroplasties. Addressing bone loss resulting from the procedure further complicates salvage procedures. Larger cohorts and extended studies are necessary to establish efficacy of first MTPJ arthroplasty. Decisions must weigh the trade-offs between pain relief and potential complications, requiring thorough patient-surgeon discussions.

Outcomes following minimally invasive dorsal cheilectomy for hallux rigidus: A systematic review.

BACKGROUND: Cheilectomy of the 1st metatarsophalangeal joint (MTPJ) is one of the most common procedures for the management of hallux rigidus. However, there is no consensus regarding outcomes following minimally invasive dorsal cheilectomy (MIDC) for the management of hallux rigidus. AIM: To evaluate outcomes following MIDC for the management of hallux rigidus. METHODS: During November 2023, the PubMed, EMBASE and Cochrane Library databases were systematically reviewed to identify clinical studies examining outcomes following MIDC for the management of hallux rigidus. RESULTS: Six studies were included. In total, 348 patients (370 feet) underwent MIDC for hallux rigidus at a weighted mean follow-up of 37.9 ± 16.5 months. The distribution of patients by Coughlin and Shurna's classification was recorded in 4 studies as follows: I (58 patients, 27.1%), II (112 patients, 52.3%), III (44 patients, 20.6%). Three studies performed an additional 1st MTPJ arthroscopy and debridement following MIDC. Retained intra-articular bone debris was observed in 100% of patients in 1 study. The weighted mean American orthopedic foot and ankle society score improved from a preoperative score of 68.9 ± 3.2 to a postoperative score of 87.1. The complication rate was 8.4%, the most common of which was persistent joint pain and stiffness. Thirty-two failures (8.7%) were observed. Thirty-three secondary procedures (8.9%) were performed at a weighted mean time of 8.6 ± 3.2 months following the index procedure. CONCLUSION: This systematic review demonstrated improvements in subjective clinical outcomes together with a moderate complication rate following MIDC for the management of hallux rigidus at short-term follow-up. A moderate re-operation rate at short-term follow-up was recorded. The marked heterogeneity between included studies and paucity of high quality comparative studies limits the generation of any robust conclusions.

Minimally invasive Dorsal cheilectomy and Hallux metatarsophalangeal joint arthroscopy for the treatment of Hallux Rigidus.

BACKGROUND: Minimally invasive dorsal cheilectomy (MIDC) has become a popular alternative to an open approach for treating Hallux Rigidus (HR). To reduce some of the complications related to the MIDC approach, a first metatarsophalangeal (MTP) joint arthroscopy can be performed in addition to address the intra-articular pathology associated with Hallux Rigidus. This study aims to examine the effectiveness of MIDC with first MTP arthroscopy in patients with HR with a minimum 1-year follow-up. METHODS: This was a multicenter retrospective review for adult patients with Coughlin and Shurnass Grade 0-3 who were treated with MIDC and first MTP arthroscopy between 3/1/2020 and 8/1/2022, with at least one year of follow-up data. Demographic information, first MTP range of motion (ROM), visual analog scale (VAS), Manchester-Oxford Foot Questionnaire (MOXFQ), and EQ-5D-5 L scores were collected. Continuous data was expressed as a mean and standard deviation, categorical data was expressed as a percentage. Wilcoxon Rank Sum test was used to compare continuous variables. All P < 0.05 was considered significant. RESULTS: A total of 31 patients were included in the study. Average follow-up time was 16.5 months (range: 12 to 26.2). There was 1 (3.2%) undersurface EHL tendon tear, 2 (6.5%) conversions to an MTP fusion, and 1 (3.2%) revision cheilectomy and capsular release for MTP joint contracture. There was a significant improvement in patient's ROM in dorsiflexion (50 vs 89.6 degrees, P = 0.002), postoperative VAS pain scores (6.4 vs 2.1, P < 0.001), MOXFQ pain scores (58.1 vs 30.7, P = 0.001), MOXFQ Walking/Standing scores (56.6 vs 20.6, P = 0.001), MOXFQ Social Interaction scores (47.3 vs 19.36, P = 0.002), and MOXFQ Index scores (54.7 vs 22.4, P < 0.001). CONCLUSION: We found that MIDC with first MTP arthroscopy was effective at improving patient-reported outcomes at one year with low complication and revision rates. These results suggest that MIDC with first MTP arthroscopy is an effective treatment for early-stage HR. LEVEL OF EVIDENCE: IV.

A Patient-Reported Outcome-Based Comparison of Cheilectomy With and Without Proximal Phalangeal Dorsiflexion Osteotomy for Hallux Rigidus.

INTRODUCTION: This study provides the first comparison of patient-reported outcomes between isolated cheilectomy (C) and cheilectomy with Moberg (CM) osteotomy for hallux rigidus. METHODS: A single-center, retrospective registry search identified all patients with preoperative Patient-Reported Outcomes Measurement Information System (PROMIS) scores who underwent cheilectomy, with and without concomitant proximal phalangeal dorsiflexion osteotomy, for hallux rigidus between January 2016 and December 2020. Because there were far fewer isolated cheilectomies (62), all C patients were compared with a commensurate number of consecutive CM cases (67) using preoperative, 1-year, and 2-year PROMIS scores for physical function, pain interference, pain intensity, global physical health, global mental health, and depression, as well as complication and revision data from a chart review. A multivariable linear regression analysis was performed to compare adjusted postoperative PROMIS scores between the 2 cohorts. RESULTS: There were no differences between groups among the demographic and preoperative variables compared. The CM cohort reported worse pain interference scores preoperatively (P < .001) and at 1 year postoperatively (P = .01). However, the C cohort reported worse pain intensity scores preoperatively (P < .001) and at 1 year postoperatively (P < .001). Adjusted postoperative PROMIS score comparison demonstrated that the CM cohort had better 1-year postoperative pain intensity scores (P < .05). However, there were no differences between cohorts for additional PROMIS scores or complications data. CONCLUSION: The addition of a Moberg osteotomy does not appear to significantly change short- to medium-term outcomes of cheilectomy for hallux rigidus treatment. LEVELS OF EVIDENCE: Level III: Retrospective comparative study.

The Aggressive Open Anterior Ankle Cheilectomy as Joint Salvage for Anterior Ankle Impingement Syndrome and Arthritis.

Anterior ankle impingement syndrome can frequently present in athletes and post-traumatic patients who have osteophytes contributing to limited dorsiflexion and pain. Surgical treatment options include arthroscopy, open arthrotomy, arthrodesis, and total implant arthroplasty. For many, joint-sparing arthroscopy or arthrotomy yield satisfactory results if significant debridement is performed. If debridement is not aggressive, patients may not obtain the desired improvement. In cases where a larger amount of bone must be removed, or the patient does not have an anatomic appearing talar neck due to osteophytic changes, we have found that an open approach is necessary to achieve good results. To the best of our knowledge, no such technique has been previously published detailing a standard approach to open ankle arthrotomy. Our technique is coined the "Aggressive Open Anterior Ankle Cheilectomy" and involves a systematic 3-step approach. First, the tibial osteophytes are resected with an osteotome; second, the ankle gutters are addressed, and all hypertrophic bones removed; and third, an anatomic talar neck is fashioned. We herein describe our surgical technique and case examples.Level of Evidence: 5.

Gait and dynamic pedobarographic analyses in hallux rigidus patients treated with Keller's arthroplasty, arthrodesis or cheilectomy 22 years after surgery.

Background: Keller's arthroplasty, arthrodesis and cheilectomy are well-known surgical interventions for hallux rigidus. This study aimed to evaluate the effects of these surgical interventions on gait, plantar pressure distribution and clinical outcome in patients treated for hallux rigidus 22 years after surgery. Methods: Spatio-temporal gait parameters and plantar pressure distribution, determined as pressure time integrals (PTIs) and peak pressures (PPs), were analyzed using a 7-foot tone analysis model. Patient-reported outcome was assessed using the Manchester-Oxford Foot Questionnaire (MOXFQ). Of the 73 patients (89 feet) from the original study, 27 patients (33 feet) and 13 healthy controls (26 feet) were available for evaluation 22 years after hallux rigidus surgery. Results: Spatio-temporal gait parameters were comparable between all groups and were in line with healthy controls (P > 0.05). No differences (P > 0.05) in PTIs and PPs were found in the seven plantar zones between groups and as compared to healthy controls. MOXFQ scores in all domains (walking/standing, range 21.4-24.1; pain, range 16.5-22.2 and social interaction, range 23.8-35.4) were not clinically and statistically different (P > 0.05) between the three different surgical interventions. Conclusion: These results suggest no long-term functional and biomechanical differences after these surgical interventions for hallux rigidus correction. The interventions seem to be appropriate treatment options for a selective group of patients with symptomatic hallux rigidus.

Percutaneous arthroscopically assisted cheilectomy combined to percutaneous proximal phalanx osteotomy in hallux rigidus: Clinical and radiological outcomes in 30 feet at a 48-month follow-up.

BACKGROUND: Hallux rigidus is a degenerative condition affecting the middle age population. It affects patients by limiting their first metatarsophalangeal range of motion (ROM) and also, their shoe wear. The objective of our work was to present an original operative technique which preserves the native joint and improves pain with minimal complications. METHODS: We conducted a retrospective multicenter cohort study of 28 patients (30 feet) suffering from moderate hallux rigidus, operated between October 2010 and October 2017 with at least 48months of follow-up. Clinical and radiological assessments included pre- and postoperative ROM, the American Orthopedic Foot and Ankle Society (AOFAS) score and forefoot radiological evaluation. No patients were lost to follow-up. RESULTS: The mean AOFAS score increased from 59 (range, 51 to 67) preoperatively to 84 (range, 80 to 88) at final follow-up. A total of 37 patients (97%) were satisfied. From a ROM point of view, this remained relatively unchanged between preoperative and postoperative values. CONCLUSION: The percutaneous arthroscopically assisted cheilectomy combined with a percutaneous proximal phalanx osteotomy, significantly improves pain in hallux rigidus with index minus in patients with Coughlin stage I and II after a mean of 4-year follow-up. LEVEL OF EVIDENCE: IV.

A Retrospective Study Assessing the Clinical Outcomes After Cheilectomy and Subchondroplasty for Hallux Rigidus.

Introduction Hallux rigidus (HR) refers to osteoarthritis of the first metatarsal phalangeal joint, resulting in stiffness, pain, and limitation in daily function. Surgery of HR is indicated in those who have failed a trial of non-operative management and is typically divided into joint-preserving (JP) and joint-sacrificing procedures. Cheilectomy is the most commonly practiced JP procedure, often done in conjunction with associated procedures for HR. Our paper aims to report the clinical outcomes after cheilectomy and cheilectomy done with subchondroplasty (SCP) performed for HR. Methods All patients who underwent cheilectomy for HR between 2017 and 2022 were identified and had their outcomes evaluated at the time of this review. The patients had their pre-operative radiographs and clinical and operative notes analyzed for the grading of HR. Functional outcomes were assessed with the use of the visual analog scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) scores, as well as comparing the pre-operative and post-operative degree of dorsiflexion of the affected first metatarsophalangeal joint. This study was approved by the SingHealth Institutional Review Board (IRB) Institution with approval number 2021/2629. Results A total of 19 patients and 20 feet were included in our study at a mean follow-up of 29.8 months. There was an increase in dorsiflexion of the first MTP joint by 27.2 degrees (p-value = <0.0001). Patients who underwent cheilectomy alone (Group 1) had a mean improvement in VAS scores of 5.46 (p-value = <0.0001). Patients who underwent SCP of the first metatarsal head along with cheilectomy (Group 2) had an improvement in VAS scores by 5.78 (p-value = 0.0007). There was a mean improvement in AOFAS scores of 25.6 (p-value = <0.0001) for patients in Group 1. Patients in Group 2 had a mean improvement in AOFAS scores of 31.0 (p-value = 0.0003). Conclusion Both cheilectomy and cheilectomy performed with SCP for HR show good outcomes at short-term follow-up (mean 29.8 months). Cheilectomy is a viable alternative to arthrodesis for the surgical treatment of HR even in patients with higher grades. The use of SCP should be further explored as an adjunct in the surgical treatment of HR.

Cheilectomy Alone in Patients With Elevatus Yields Poor 5-Year Survival Rate.

This study was performed to evaluate the efficacy of the cheilectomy procedure for different degrees of elevatus. The study was Institutional Review Board approved and patients were evaluated retrospectively at Ascension St. John Hospital, St. John Surgery Center and St. John Macomb Township Surgery Center between 9/8/2012 and 1/8/2016. These were all performed by the same surgeon. The pre- and postoperative radiographs were analyzed and Seiberg's index was calculated. Charts were also reviewed, and demographic information was obtained. A telephone survey was performed, and Visual Analog Pain score and Foot and Ankle Ability Measure was obtained. Body mass index, age, calcaneal inclination angle, Seiberg's index, Foot and Ankle Ability Measure, and visual analog score were analyzed using chi-square test, bivariate regression analysis and independent t test. Seiberg's index had a statistically significant influence on 5-year survival rate for the cheilectomy procedure (p ≤ .05). For patients with Seiberg's index less than 0.20 cm demonstrated FAAM, and VAS p values .18 and .37 with 87.0% 5-year survival. Seiberg's index between 0.20 and 0.40 cm had FAAM and VAS scores with p values <.01 and .02 with 62.0% 5-year survival. Seiberg's index ≤0.40 cm p values <.01 and .55 with 5-year survival rate of 0.0%. Therefore, if Seiberg's index is greater than 0.20 cm based on this research a cheilectomy alone as a sole treatment is at greater risk of failure.

Synthetic cartilage implant hemiarthroplasty versus cheilectomy for the treatment of hallux rigidus.

Degenerative arthritis of the first metatarsophalangeal joint, hallux rigidus, is the most common type of arthritis of the foot, affecting nearly 2.5% of the population over the age of 50. Hallux rigidus can be treated surgically with either Cheilectomy or Synthetic cartilage implant (SCI) hemiarthroplasty. The purpose of this study is to compare outcomes from a single institution on the treatment of hallux rigidus using cheilectomy and SCI hemiarthroplasty. Between 2012 and 2020, 49 patients underwent either a SCI (Polyvinyl alcohol hydrogels) hemiarthroplasty or Cheilectomy for the treatment of hallux rigidus. Functional scores were assessed pre and postoperatively using the American Orthopedic Foot and Ankle scoring System (AOFAS) and the Foot and Ankle Outcome Score survey (FAOS). Plantar and Dorsal range of motion was also assessed pre and postoperatively. Outcomes, complications, and any reoperations were recorded for all patients. Mean pre-op AOFAS for Cheilectomy and SCI were 49.6 and 54.8, respectively, compared to 85.3 and 89.7, respectively, after surgery (p value < 0.05). Mean pre-op Dorsal range of motion (ROM) for Cheilectomy and SCI were 24.0 and 26.0 degrees, respectively, compared to 38.0 and 42.6 degrees, respectively, after surgery (p value < 0.05). SCI hemiarthroplasty patients had higher AOFAS and dorsal ROM at the latest follow up (p value < 0.05). Synthetic cartilage implant (SCI) hemiarthroplasty and cheilectomy both offer promising results and remain viable treatment options to decrease pain, improve function, and maintain motion for hallux rigidus. SCI hemiarthroplasty may offer superior range of motion and functional outcomes than cheilectomy for hallux rigidus. LEVEL OF CLINICAL EVIDENCE: 3.

Sliding Oblique Metatarsal Osteotomy Fixated With K-Wires Without Cheilectomy for All Grades of Hallux Rigidus: A Case Series of 76 Patients.

Background: Studies on decompression metatarsal osteotomy without cheilectomy for hallux rigidus are limited. This study aimed to review the data of patients who underwent this surgery for all grades of hallux rigidus. Methods: The medical records of patients who underwent this surgery between August 2017 and January 2021 were retrospectively reviewed. The outcomes were assessed using the visual analog scale (VAS), the Japanese Society for Surgery of the Foot (JSSF) score, and the hallux dorsiflexion angle. Patients who were followed up for more than 2 years were included. The plantar shift of the first metatarsal head (PS) and the shortening of the first metatarsal (SH) were measured to supplementally investigate the associations with other measurements. Results: A total of 76 patients (female, 42; male, 34; mean age, 60.3 years; mean body mass index, 23.1) with 80 feet were enrolled. Six patients (7.5%) were grade 1, 20 (25.0%) were grade 2, 30 (37.5%) were grade 3, and 24 (30.0%) were grade 4. The mean follow-up duration was 3.5 years. Overall, the mean VAS score improved from 63.2 to 6.2, the mean JSSF score from 59.0 to 82.6, and the mean dorsiflexion angle from 37.3 to 56.3 degrees. These measures improved for all grades, but the dorsiflexion angles and JSSF scores decreased as the grade advanced. No clear associations were found between the postoperative VAS and the PS and SH. Eight patients (10.5%) had complications: 4 (5.2%) had occasional plantar discomfort under the metatarsal head, 2 (2.6%) required shoe modification, 1 (1.3%) had wound pain, and 1 (1.3%) experienced breakage of a K-wire. Conclusion: The VAS scores, dorsiflexion angles, and JSSF scores improved for all grades of hallux rigidus within a relatively short period of follow-up; however, the dorsiflexion angles and JSSF scores decreased as the grade advanced. Level of Evidence: Level IV, retrospective case series.

Effect of Prior Cheilectomy on Outcomes of First Metatarsophalangeal Joint Fusion for Treatment of Hallux Rigidus.

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.