Free gracilis interposition arthroplasty for severe hallux rigidus.

Surgery for the management of hallux rigidus aims to relieve pain and improve function. Arthrodesis, though reliable in terms of pain relief may encounter some resistance from patients reluctant to have a fusion. Results of other techniques, such as silastic implants, may give poor long-term results. Excisional arthroplasty and cheilectomy are also routinely used. Interposition arthroplasty has been used with some success in other joints. We describe a technique of autologous interposition arthroplasty using a free ipsilateral gracilis tendon graft for patients with severe hallux rigidus with moderate to high activity levels and who do not wish to undergo fusion.