Keller arthroplasty vs hemi-implant arthroplasty for the surgical treatment of hallux rigidus: Mid-term comparative analysis

Introduction

There is no clear consensus regarding the best surgical treatment options in patients with hallux rigidus. The present study compares the effectiveness of two commonly used techniques in advanced cases of hallux rigidus: Keller arthroplasty and hemi-implant arthroplasty.

Patients and methods

All cases of hallux rigidus that underwent surgical treatment with either Keller or hemi-implant arthroplasties during the year 2004 were analyzed. AOFAS scale and angles in A/P X-rays were used to compare at the preoperative moment and at 6 months, 1, 3 and 5 years postoperatively.

Results

A total of 54 feet were included in the study (27 in each group of treatment). No differences were observed between groups in the AOFAS scale in all the postoperative moments analyzed. Significant differences were observed in the AOFAS score and in the complications of the techniques in each separate group by age factor.

Discussion

The results of the techniques of podiatric surgery of Keller and hemi-implant arthroplasty seem to be dependent on the age of the patient and progress time. Keller arthroplasty has offered better results in patients over 55, independently of the sex, but transfer metatarsalgia at 3 and 5 years is a common postoperative finding. The hemi-implant procedure seems to be more beneficial in patients less that 55.