Long-term Return to Sports After Modified Oblique Keller Capsular Interposition Arthroplasty vs Arthrodesis for Advanced Hallux Rigidus: A Retrospective Cohort.

BACKGROUND

Modified oblique Keller capsular interposition arthroplasty (MOKCIA) is a treatment for hallux rigidus that has been shown to have similar long-term outcomes compared with metatarsophalangeal (MTP) arthrodesis. The purpose of this study was to evaluate differences in the level of sport and other activity following MOKCIA or first MTP arthrodesis.

METHODS

From 2005 to 2020, 58 MOKCIA and 112 arthrodesis patients were identified. Patients completed a sports-specific questionnaire (SSQ) along with the visual analog scale (VAS) pain/satisfaction, Foot and Ankle Ability Measure (FAAM), and Patient-Reported Outcomes Measurement Information System (PROMIS) instruments, which yielded 14 MOKCIA and 15 arthrodesis subjects.

RESULTS

At an average 13 years' follow-up, the MOKCIA group participated in a mean of 3.4 ± 1.7 sport activities preoperatively and 3.4 ± 1.9 postoperatively, whereas arthrodesis patients participated in 3.5 ± 1.7 activities preoperatively and 2.9 ± 1.4 postoperatively (P = .22). Compared with preoperative, the MOKCIA group rated sporting activities as less difficult (10/12) and same difficulty (2/12). Hundred percent of patients in the MOKCIA group were satisfied with their overall level of activity following surgery, whereas 87% patients (13/15) in the arthrodesis group were satisfied. Patients in the MOKCIA group were able to participate in similar numbers of activities postoperatively, but arthrodesis patients had decreased activities. PROMIS, VAS pain/satisfaction, and FAAM Sports scores were similar between the groups.

CONCLUSION

We found that MOKCIA compared similarly with MTP arthrodesis in sports physical function at long-term follow-up. These results must be interpreted in light of the very low follow-up and retrospective recall of preoperative activities.

LEVEL OF EVIDENCE: Level III, retrospective cohort study.