Prospective gait analysis in patients with first metatarsophalangeal joint arthrodesis for hallux rigidus.

BACKGROUND: Arthrodesis of the first metatarsophalangeal (MTP) joint is a common procedure with a proven long-term success rate. However, there is limited scientific information on its functional results. There is little data in the literature about changes in gait parameters after first MTP joint arthrodesis. The purpose of this study was to objectively evaluate the effects of first MTP joint arthrodesis on gait.

METHODS: Twenty-three patients with symptomatic hallux rigidus refractory to nonoperative treatment were treated with first MTP joint arthrodesis. A prospective gait analysis study was performed on all patients at an average of 8.6 days before surgery and then again at least 1 year postoperatively. Preoperative and postoperative data from the patients were compared to determine differences in clinically relevant temporal-spatial, kinematic, and kinetic parameters of gait.

RESULTS: There were three statistically significant changes in gait: increases in maximal ankle push-off power and single-limb support time on the involved extremity, and a decrease in step width.

CONCLUSIONS: First MTP joint arthrodesis produces objective improvement in propulsive power, weightbearing function of the foot, and stability during gait.