Functional Outcome Analysis of Hallux Rigidus Patients Undergoing Cheilectomy vs. Cheilectomy and Proximal Phalanx Osteotomy: A Patient¬ís Perspective
- *Corresponding Author:
- Thomas G Harris, MD
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Received Date: September 28, 2014; Accepted Date: December 22, 2014; Published Date: December 26, 2014
Citation: Warganich T, Weksler M, Harris T (2014) Functional Outcome Analysis of Hallux Rigidus Patients Undergoing Cheilectomy vs. Cheilectomy and Proximal Phalanx Osteotomy: A Patient’s Perspective. Orthop Muscul Syst 3: 180. doi: 10.4172/2161-0533.1000180
Copyright: © 2014 Warganich T, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: The primary aim of this study is to evaluate the functional outcomes of two surgical treatment groups with hallux rigidus. Our goal was to better understand the post-surgical outcomes between the two treatment groups from a practical, patient-centered point of view.
Methods: A retrospective case series of 63 patients with hallux rigidus undergoing cheilectomy (C group) or a cheilectomy plus proximal phalanx osteotomy (CPP group) over a 4-year period with a minimum clinical follow up of 12 months. Evaluation of the study was based on satisfaction scores, VAS score, functional outcomes, and radiographs.
Results: There were 32 patients in the C group and 31 in the CPP group. The median months to “100% recovery” was 3.5 months in the C group vs. 9 months for the CPP group. Time to normal shoes and overall satisfaction with either surgery was nearly identical in both groups (30 days for C vs. 28 days for CPP and a mean satisfaction score of 8.4 for group C and 8.2 for group CPP). Both treatment groups had similar percentages of patients report less post-operative pain than expected (34% C vs. 33% CPP). A higher percentage of patients in the C group (56%) reported more pain than expected compared to the CPP group (40%). Also in both groups the VAS pain level decreased significantly.
Discussion: In our study, we found that although CPP is a longer procedure, patients had an earlier return to full weight bearing but a much longer subjective, patient reported “100% recovery.” However, the time to regular shoes remained the same in each group and overall means satisfaction score was similar. Interestingly, more patients in the cheilectomy only group reported their post-op pain to be higher than expected suggesting patients were underestimating their post-op course or receiving sub-optimal pre-operative counselling.