Both first metatarsophalangeal arthrodesis and Swanson silastic arthroplasty are established treatments for the management of end-stage hallux rigidus; identifying the specific outcomes and complications associated with each can represent a challenge when consenting patients.
PROMs data and clinical outcomes were compared for consecutive series of patients who had received either procedure as surgical management of end-stage hallux rigidus.
There were 61 patients in each group. Patient satisfaction was 87% following arthrodesis and 73% following silastic arthroplasty. Over 80% of patients had an improvement in post-operative PROMs following either procedure. There was a significant difference in mean improvement in favour of arthrodesis (MOXFQ p = 0.0004, VAS p = 0.002). Metalwork removal was required in 8.2% of patients following arthrodesis; ongoing pain had been documented in 19.7% of patients following silastic arthroplasty.
Both procedures remain effective treatment options for end-stage hallux rigidus; local data can be used when counselling patients pre-operatively.