Deland's 2012 JAAOS review synthesizes the surgical options for hallux rigidus — the most common degenerative joint disease of the foot — and asks: which procedure is appropriate at each stage of disease severity, and what does the outcome literature actually support?
When staging hallux rigidus, the key clinical question is whether pain occurs in the midrange of passive motion — if yes, that's grade 4 and cheilectomy will likely fail; go directly to arthrodesis or, in patients over 70, Keller resection arthroplasty.
For grades 1–3 without midrange pain, cheilectomy with or without phalangeal osteotomy is the appropriate first surgical step.
Deland's 2012 JAAOS review synthesizes the surgical options for hallux rigidus — the most common degenerative joint disease of the foot — and asks: which procedure is appropriate at each stage of disease severity, and what does the outcome literature actually support?
When staging hallux rigidus, the key clinical question is whether pain occurs in the midrange of passive motion — if yes, that's grade 4 and cheilectomy will likely fail; go directly to arthrodesis or, in patients over 70, Keller resection arthroplasty.
For grades 1–3 without midrange pain, cheilectomy with or without phalangeal osteotomy is the appropriate first surgical step.