Background

There is a lack of research providing a biomechanical outcome following 1^st MTPJ replacement for hallux rigidus. Despite this, 1^st MTPJ replacement continues to be an alternative surgical option to fusion for this painful debilitating condition. Several studies do consider the patient reported outcomes which are subjective.

Research Question

The objective of this study is to provide an in depth biomechanical analysis to examine the effects of 1^st MTPJ replacement for hallux rigidus on gait mechanics.

Methods

Kinematic data was collected at our CMAS (Clinical Movement Analysis Society) UK accredited gait laboratory during the gait cycle together with pressure plate pressure readings and a validated patient outcome measure before surgery and at 6 and 12 months after surgery. A complete literature review is performed.

Results

Kinematic data revealed a significant increase in stride length, cadence and velocity following 1^st MTPJ replacement for hallux rigidus. Foot kinematic data revealed significantly reduced tibia-hindfoot abduction and pronation and reduced hindfoot-forefoot supination and adduction. There was no effect on 1^st MTPJ weight bearing range of motion. Pressure plate data revealed an increase in peak pressure and pressure time integral towards the 1^st metatarsal following surgery. There was a significant improvement in the patient reported outcome measure.

Significance

This study has demonstrated objectively that following 1^st MTPJ replacement, biomechanically, a restoration of the foot posture to allow medialisation of foot pressures towards the medial column and normalisation of gait including an increase in the stride length, cadence and velocity and that clinically, there was an improvement in the MOXFQ.

中文翻译：

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第一次跖趾关节置换术后足部的前瞻性临床和生物力学分析

背景

在^第一次MTPJ 替代拇趾僵硬后，缺乏提供生物力学结果的研究。尽管如此，第^一次MTPJ 置换仍然是这种令人痛苦的衰弱状况融合的替代手术选择。一些研究确实考虑了患者报告的主观结果。

研究问题

本研究的目的是提供深入的生物力学分析，以检查第^一次MTPJ 替代拇趾僵硬对步态力学的影响。

方法

在步态周期期间，在我们的 CMAS（临床运动分析协会）英国认可的步态实验室收集运动学数据，以及手术前和手术后 6 个月和 12 个月的压力板压力读数和经过验证的患者结果测量。进行了完整的文献回顾。

结果

运动学数据显示，在^第一次MTPJ 替代拇趾僵硬后，步幅、节奏和速度显着增加。足部运动学数据显示胫骨-后足外展和旋前显着减少，后足-前足旋后和内收显着减少。对第^一次MTPJ 承重的运动范围没有影响。压力板数据显示在峰值压力和加压时间朝向1个积分的增加^第一跖骨下面的手术。患者报告的结果测量有显着改善。

意义

该研究客观地表明，在第^一次MTPJ 置换后，在生物力学上，足部姿势的恢复使足部压力向内侧柱内侧化和步态正常化，包括步长、步频和速度的增加，并且在临床上，是 MOXFQ 的改进。