This article reviews current literature available on hallux rigidus including its pathophysiology, clinical evaluation, operative and non-operative management.
An estimated 40 percent of the United States population have foot problems; of all patients aged over 50 years, 2.5 percent report degenerative arthritis of the first metatarsophalangeal (MTP) joint, termed ‘hallux rigidus’.
While arthritis can be caused by traumatic or iatrogenic injuries that directly cause damage to the articular cartilage of the MTP joint, most often the aetiology of hallux rigidus is idiopathic.
As hallux rigidus progresses, the normal coupling of the centre of rotation of the proximal phalanx and metatarsal head is disrupted, leading to eccentric gliding of proximal phalanx on the metatarsal head.
Patients typically present with a history of pain and stiffness that is worse with activities, particularly with first MTP dorsiflexion involvement, such as stairs, running or push-ups.
On examination, tenderness is localised to the dorsal joint and osteophytes can often be visualised and palpated.
Imaging should consist of standing anteroposterior (AP), oblique and lateral radiographs.
Treatment of hallux rigidus should begin with non-operative measures aimed at pain relief.
Non-steroidal anti-inflammatory drugs may alleviate acute episodes of exacerbation.
Activity modifications include avoiding those that involve extreme dorsiflexion of the first MTP such as stairs or running.
Orthotics are designed to limit motion across the first MTP joint while providing cushioning and plantar pressure distribution.
Non-operative treatment can be successful for many patients.
For patients with severe hallux rigidus, the ‘gold standard’ remains first MTP arthrodesis, where retrospective series as well as comparative studies have shown consistent success.
Newer techniques of interpositional arthroplasty as well as new hemi-arthroplasty designs, including metal resurfacing and synthetic cartilage implants, offer potentially promising options for preservation of motion.
Copyright 2018 MASS4D® All rights reserved.
Rehabilitation of Your Foot and Lower Back Conditions.
Long Lasting Wear
Strong Foot Support
Easy to use
Handmade MASS4D® Quality
Sign up for free recommended foot exercises, stretching, medical news and everything good for your feet
Please have a a look at our medical reviews and clinical articles on everything about lower biomechanics.
You should always seek the advice of a physician or other qualified healthcare provider with any questions regarding personal health or medical conditions.
The content, products and services offered herein, are here to educate consumers on healthcare and medical issues that may affect their daily lives. Nothing in the content, products or services should be considered, or used as a substitute for, medical advice, diagnosis or treatment. This site and its services do not constitute the practice of any medical, nursing or other professional healthcare advice, diagnosis or treatment.
The marks "MASS4D" and the MASS4D logo are trademarks. The content and design of MASS4D.com is protected by U.S. and international copyright laws. You may not copy, reproduce, republish, upload, post, display, transmit or frame any of these materials without prior written consent from MASS4D®.
The content, products or services on this site should not be considered or used as a substitute for medical advice, diagnosis or treatment and is not intended to provide individual medical advice. Included materials and conversations do not imply a personalised doctor-patient relationship.
Copyright and Intellectual property
MASS4D® is owned and operated by Scheibye General Trading LLC - Licence no: 853463
MASS4D® and Logo are registered trademarks of MASS4D Inc. All content, trademarks, artwork, and associated imagery are trademarks and/or copyright material of MASS4D® Inc.