Return to sport after arthrodesis and implant arthroplasty for hallux rigidus : a systematic review.

BACKGROUND

Painful, degenerative stiffening of the first metatarsophalangeal (MTP-1) joint, as seen in hallux rigidus, is common among athletic individuals due to repetitive microtrauma. While arthrodesis of the MTP-1 joint is considered the gold standard for advanced degeneration, the resulting loss of motion may impair sports and recreational activities. Implant arthroplasty, by preserving joint mobility, may offer functional benefits for active patients.

METHODS

In accordance with PRISMA guidelines, a comprehensive literature search was conducted using PubMed, LIVIVO, the Cochrane Controlled Trials Library, Science Direct, CINHAL and Scopus. Studies reporting on sports function after MTP-1 arthrodesis or implant arthroplasty for degenerative arthritis were included. Fifteen studies with 1,103 procedures met the inclusion criteria. Sport-specific outcomes and functional scores were extracted and analyzed.

RESULTS

Data on sports function following MTP-1 arthrodesis and implant arthroplasty are heterogeneous, limiting direct comparison. Arthrodesis studies reported return-to-sport rates of up to 100%, with a shift from high-impact to in-line activities. Implant arthroplasty showed similar return-to-sport rates, with potential short-term functional benefits. However, long-term superiority could not be demonstrated, and higher complication rates must be considered.

CONCLUSION

MTP-1 arthrodesis remains a reliable treatment for end-stage hallux rigidus, offering satisfactory long-term sports function. Implant arthroplasty may provide short-term advantages in active patients but carries a higher risk of complications and has not shown superior long-term outcomes in sports participation.