Minimally invasive arthroscopic-assisted arthrodesis of the first metatarsophalangeal joint

Objective Clinical and radiographic analysis of a minimally invasive arthrodesis technique of the first metatarsophalangeal joint. Indications Symptomatic hallux rigidus, symptomatic hallux rigido-valgus, hallux varus. Contraindications Absolute contraindication (CI): osteomyelitis; relative CI: untreated diabetes mellitus, smoking. Surgical technique Under arthroscopic assistance, a minimally invasive arthrodesis technique of the first metatarsophalangeal joint is performed with removal of the subchondral sclerosis and remaining cartilage of the osteoarthritic joint. Postoperative management Immediate weight-bearing starts on day 1 using a ready-made hallux valgus shoe for 6 weeks. Physiotherapy without movement of the first metatarsophalangeal joint is allowed after surgery. Results A series of 5 patients with symptomatic hallux rigidus and relevant medical diseases were evaluated after minimally invasive arthroscopic arthrodesis of the first metatarsophalangeal joint. In all cases osseous union was found after 8.4 months. Follow-up was 22.6 months and the American Orthopedic Foot and Ankle Society (AOFAS) score increased significantly from 42.4 to 82.8 points. No complications requiring therapy were observed in our cohort nor was revision surgery necessary. The results of our series are in line with the published results of minimally invasive fusion techniques of the first metatarsophalangeal joint.