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Long-Term Results Following Keller Resection Arthroplasty for Hallux Rigidus

Background: We assessed the long-term results following Keller resection arthroplasty for the treatment of hallux rigidus. We then compared them with alternative surgical methods like cheilectomy, arthrodesis and joint replacement. Methods: Eighty-seven cases of Keller resection arthroplasty for hallux rigidus were reviewed with mean followup of 23 years. Their mean age at time of surgery was 50 years. Analysis included personal clinical evaluation with the AOFAS Hallux Score, quality-of-life assessment using the SF-36, radiographic assessment, pedobarographic evaluation and analysis of the patients' charts to detect any postoperative complications. Results: At the time of followup only five (5%) feet had undergone revision surgery. For all other cases we calculated a mean AOFAS score of 83 points. Sixty-nine of 73 unrevised patients (94%) would opt for this operation again under the same circumstances. SF-36 parameters showed age related normal values. Pedobarographic assessment revealed only moderate weightbearing alterations. Our long-term results compare favorably with published results following arthrodesis, cheilectomy or joint replacement for the treatment of painful hallux rigidus. Clinical results and subjective assessments were very good and complication rates were low compared to competing methods. Conclusion: Keller resection arthroplasty remains a valuable surgical option for the treatment of advanced stages of hallux rigidus with high patient satisfaction, moderate weightbearing alterations and comparable low complication rate in our experience. Level of Evidence: IV, Retrospective Case Series