Efficacy of First MTPJ Arthrodesis as a Treatment in Hallux Rigidus

Exclusion Criteria

• •ASA\* physical status classification level III or higher
• •Patients with weak co-operation (dementia, schizophrenia, etc.)
• •Patients with neuropathy, i.e. unable to feel 10g monofilament pressure in less than 8 out of 10 standard testing sites
• •Active bacterial infection or ulcer of the lower limb
• •Diabetes mellitus with insulin treatment
• •Diabetes mellitus and GHb-A1C \>64 mmol/mol (regardless of treatment)
• •History of rheumatoid arthritis, gout or other inflammatory arthritis of the foot
• •Hallux valgus angle \>15° in weight-bearing X-ray
• •Hallux varus in weight-bearing X-ray
• •Large bone cysts in X-ray probably requiring bone grafting in surgery
• •Pain in passive manipulation of ipsilateral first toe IP joint
• •Patients with severe circulatory disorder of the lower limb: absence of palpable pulses in the foot (both dorsalis pedis artery and tibialis posterior artery)
• •History of surgery of the foot in question
• •Neuropathic pain of the foot in question (i.e., use of neuropathic analgesics)
• •Activity limiting symptoms from an earlier fracture or ligament injury of the foot
• •Patient is not willing to accept the operation within the planned time limits (3 to 12 weeks post-randomisation)