[Hallux rigidus].

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Abstract

[Indexed for MEDLINE] 16. Foot Ankle Surg. 2022 Jun;28(4):526-533. doi: 10.1016/j.fas.2022.02.019. Epub 2022 Mar 2. Keller's arthroplasty for hallux rigidus: A systematic review. Artioli E(1), Mazzotti A(2), Zielli S(1), Bonelli S(1), Arceri A(1), Geraci G(1), Faldini C(3). Author information: (1)IRCCS Istituto Ortopedico Rizzoli, 1st Orthopaedic and Traumatologic Clinic, Via Giulio Cesare Pupilli 1, 40136 Bologna, Italy. (2)IRCCS Istituto Ortopedico Rizzoli, 1st Orthopaedic and Traumatologic Clinic, Via Giulio Cesare Pupilli 1, 40136 Bologna, Italy; Department of Biomedical and Neuromotor Sciences, University of Bologna, 40123 Bologna, Italy. Electronic address: antonio.mazzotti@ior.it. (3)IRCCS Istituto Ortopedico Rizzoli, 1st Orthopaedic and Traumatologic Clinic, Via Giulio Cesare Pupilli 1, 40136 Bologna, Italy; Department of Biomedical and Neuromotor Sciences, University of Bologna, 40123 Bologna, Italy. BACKGROUND: Several surgical procedures have been described to treat hallux rigidus. Keller arthroplasty is a joint-sacrificing procedure proposed in 1904. Considering the current trends to mini-invasiveness and the debate about the technique's suitability, this review intends to state Keller arthroplasty results and the conditions where it could be still adopted in the treatment of hallux rigidus. METHODS: Selected articles were reviewed to extract: population data, surgical indications, different surgical techniques, clinical and radiological outcomes, and complications. RESULTS: Seventeen retrospective studies were selected, counting 508 patients. Mean age at surgery was 55 years. Patients were affected by moderate-severe hallux rigidus. Three modified Keller arthroplasty were identified. Good clinical and radiological outcomes were reported. Metatarsalgia was the most frequent complication (12%). CONCLUSION: Despite for many authors KA seems a viable surgical treatment for middle aged and elderly patients affected by moderate-severe hallux rigidus, the available literature provides little evidence on the real efficacy and safety of the technique. A non-negligible percentage of complications may occur, and therefore is essential to set correct indications through an accurate patients' selection. Copyright © 2022 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved. DOI: 10.1016/j.fas.2022.02.019