Therapeutic management of the hallux rigidus

NewsBot · Sep 20, 2012

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Therapeutic management of the hallux rigidus.
Aggarwal A, Kumar S, Kumar R.
Rehabil Res Pract. 2012;2012:479046.

Background. Hallux rigidus is a chronic, disabling condition of foot characterized by reduced great toe extension. The manual therapy approaches are described theoretically however their practical published evidence has not been analyzed well.

Objective. Aim of the present paper was to systematically review the literature available for therapeutic management of the hallux rigidus by identifying and evaluating the randomized controlled trials (RCTs) and non-RCTs.

Methods. To view the hallux rigidus and its rehabilitation, a webbased published literature search of Pubmed, Ovid Medline, Science direct, Cochrane Database, PEDro database, CINAHL was conducted for last 35 years in August 2010 using 4 specific keywords "hallux rigidus, physical therapy, chiropractic, and manual therapy" typed in exactly same manner in the search column of the databases.

Result. the review finds that there is acute need of the quality studies and RCTs for the manual therapy, chiropractic, or physiotherapeutic management of the hallux rigidus.

Conclusion. Review conclude that conservative programs for hallux rigidus consists of comprehensive intervention program that includes great toe mobilization, toe flexor strengthening, sesamoid bones mobilization and long MTP joint. The clinician should put an emphasis on the mobilization program with proper follow up along with comparative studies for rehabilitation of hallux rigidus.
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Admin2 · Sep 21, 2012

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NewsBot · Jun 10, 2014

NewsBot said: ↑

Therapeutic management of the hallux rigidus.
Aggarwal A, Kumar S, Kumar R.
Rehabil Res Pract. 2012;2012:479046.
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Retracted: Therapeutic Management of the Hallux Rigidus

This retracts the article "Therapeutic Management of the Hallux Rigidus" in volume 2012, 479046, which was published in final edited form.

The paper titled “Therapeutic Management of the Hallux Rigidus” [1], published in Rehabilitation Research and Practice, has been retracted as it was found to contain substantial flaws in its scientific methodology.

References
1. Aggarwal A, Kumar S, Kumar R. Therapeutic management of the hallux rigidus. Rehabilitation Research and Practice. 2012;2012:9 pages.479046 [PMC free article] [PubMed]
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4046096/

NewsBot · Jun 30, 2014

“Substantial flaws” trip up big toe paper

Frankly, we’re not sure what “scientific methodology” the authors might have be-flawed. Did they in fact mistype the search terms, contrary to what they declared? Neither the editors nor the journal have responded to requests for comment, but we’ll update with anything we learn.
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NewsBot · Aug 12, 2014

Proposed global treatment algorithm for hallux rigidus according to evidence-based medicine.
Herrera-Pérez M, Andarcia-Bañuelos C, de Bergua-Domingo J, Paul J, Barg A, Valderrabano V
Revista Espanola de Cirugia Ortopedica y Traumatologia [2014]

INTRODUCTION: Hallux rigidus is the most common arthritis of the foot and ankle. There are numerous reviews on the surgical treatment, but few publications that address the effectiveness of conservative treatment.

OBJECTIVE: To present a comprehensive algorithm for treatment of all grades of this disease.

METHODS: Literature search in the following sources: Pubmed and PEDro database (physiotherapy evidence database) until October 2013 for articles on treatment hallux rigidus to record levels of evidence.

RESULTS: A total of 112 articles were obtained on conservative treatment and 609 on surgical treatment. Finally, only 4 met the inclusion criteria.

CONCLUSIONS: The use of orthoses or footwear modifications, infiltration with hyaluronate, cheilectomy in moderate degrees and the metatarsophalangeal arthrodesis for advanced degrees, are the only procedures contrasted with grade B or moderate evidence in the treatment of hallux rigidus.
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NewsBot · Feb 7, 2018

A comprehensive and narrative review of historical aspects and management of low-grade hallux rigidus: conservative and surgical possibilities
S. Caravelli et al
MUSCULOSKELETAL SURGERY 01 February 2018

Hallux rigidus, Latin for Stiff Toe, is characterized by an osteoarthritic degeneration of the articular surfaces of the first metatarsophalangeal joint. The aim of this literature narrative overview is to summarize and expose the great amount of management concepts and information, including the well-codified operative procedures and the more up to date knowledge about non-operative and surgical treatment of hallux rigidus. This may provide current information for physicians, medschool attendants and researchers. A comprehensive literature search using PubMed database has been performed, up to April 1, 2017. Several different types of treatment are described in the literature for low-grade hallux rigidus. The management for hallux rigidus can involve a variety of therapeutic interventions, conservative or operative. Hallux rigidus is a complex disease characterized by several clinical and pathological findings, and to achieve optimal results, surgical treatment for low-grade forms should be chosen between several surgical techniques depending on the degree of arthritis and other different clinical conditions.
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NewsBot · Jul 14, 2021

Short-term Efficacy of Ultrasonographic Guidance for Intra-articular Corticosteroid Injection in Hallux Rigidus: A Single-Blind Randomized Controlled Trial
Seyede Zahra Emami Razavi et al
Foot Ankle Int. 2021 Jun 11

Background: Multiple considerations should be taken before standardizing a clinical procedure such as efficacy, safety, or the cost. The aim of this study was to compare the effects of landmark-guided vs ultrasonography-guided intra-articular injection of corticosteroid into the first metatarsophalangeal joint cavity to reduce pain and dysfunction in patients with hallux rigidus.

Methods: We carried out a single-blind randomized controlled trial with 2 parallel arms in an outpatient clinic affiliated with a medical university. In total, 50 participants (35 women) with the mean (SD) age of 49.8 (10.3) years were randomly allocated to landmark-guided or ultrasonography-guided groups (each n = 25). Each patient received a single intra-articular injection of 40-mg methylprednisolone plus 1 mL lidocaine into the affected first metatarsophalangeal joint. The primary outcome was joint pain and the secondary outcome was the American Orthopaedic Foot & Ankle Society score. We measured the outcomes at baseline and 2 and 6 weeks after the intervention.

Results: Six weeks after the injections, there were no statistically significant differences between the study groups in pain reduction and increase in the American Orthopaedic Foot & Ankle Society scores (P = .131 and .241, respectively). We did not find any complications for the injections in both groups. There were statistically significant changes within each group in pain and the scores for the landmark (P < .001, and P = .007), and ultrasonography groups (both P < .001).

Conclusion: Landmark guidance is as effective as ultrasonographic guidance for intra-articular injection in patients with hallux rigidus. A single intra-articular injection of 40 mg methylprednisolone plus 1 mL lidocaine is an efficient and safe therapeutic measure for decreasing joint pain and maintaining its function, at least for 6 weeks.
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