Minimally Invasive vs Open First Metatarsophalangeal Joint Cheilectomy: Radiographic Outcomes and Early Complications

Document Type : RESEARCH PAPER

Authors

1 1 Foot & Ankle Research and Innovation Laboratory (FARIL), Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, USA 2 Department of Orthopaedic Surgery, Mass General Brigham, Boston, MA, USA

2 Division of Foot and Ankle Surgery, Department of Orthopaedic Surgery, Brigham and Women’s Hospital, Boston, MA, USA

3 Foot & Ankle Research and Innovation Laboratory (FARIL), Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, USA

4 1 Foot & Ankle Research and Innovation Laboratory (FARIL), Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, USA 2 Department of Orthopaedic Surgery, Mass General Brigham, Boston, MA, USA 3 Division of Foot and Ankle Surgery, Department of Orthopaedic Surgery, Brigham and Women’s Hospital, Boston, MA, USA

10.22038/abjs.2024.81570.3715

Abstract

Objectives: Current literature on surgical techniques has evaluated minimally invasive surgery (MIS) cheilectomy and its efficacy in comparison to the open technique. However, no study to date has evaluated MIS-Moberg in relation to open and MIS cheilectomy. This study assessed radiological outcomes and early healing and complications of patients who underwent open, MIS, and MIS-Moberg cheilectomies.
Methods: We conducted a retrospective cohort review of 134 patients who underwent first metatarsophalangeal (MTP) cheilectomy at an academic medical center between 2015 and 2024. Success of cheilectomy was determined radiographically. Postoperative complications were identified through medical record review.
Results: 73 open and 61 MIS cheilectomies were performed on 134 patients with a primary diagnosis of hallux rigidus. The pre-operative versus post-operative differences in dorsal cortical length (3.7±1.4) and sagittal articular P1 angle (7.3±4.8) were found to be statistically significant (P<0.05) for the MIS-Moberg group. Ten patients in the open cheilectomy were found to have dorsiflexion and plantarflexion stiffness compared to zero patients in the MIS and MIS-Moberg groups (P<0.01).
Conclusion: We showed a significantly greater rate of plantar- and dorsiflexion stiffness in open surgeries compared to MIS and MIS-Moberg. No other differences in healing rates or radiologic outcomes were observed. Based on preliminary results, the MIS-Moberg can successfully alter the radiographic alignment of the great toe and does not increase complications as compared to open or MIS cheilectomy alone.
        Level of evidence: III

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Main Subjects

References

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The Archives of Bone and Joint Surgery
Volume 13, Issue 3
March 2025
Pages 152-156

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History

  • Receive Date: 01 August 2024
  • Revise Date: 25 November 2024
  • Accept Date: 27 November 2024

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