Foot kinematics in walking on a level surface and on stairs in patients with hallux rigidus before and after cheilectomy

BACKGROUND: Walking down stairs is a clinically relevant daily activity for older persons. The aim of this pilot study was to investigate the impact of cheilectomy on walking on level ground and on stairs. METHODS: 3D motion analysis of foot kinematics was performed in eight patients with hallux rigidus and 11 healthy control participants with a 12-camera system, using the Heidelberg foot measurement method before and one year after surgery. The clinical results were documented using the AOFAS Scale. RESULTS: The range of motion of the first metatarsophalangeal joint did not improve after the operation under any gait condition. Preoperatively, hallux dorsi-/plantarflexion in level walking was 11.9° lower in patients than in controls (p = 0.006), postoperatively 14.5° lower (p = 0.004). Comparing walking conditions in patients, hallux dorsi-/plantarflexion was significantly higher in level walking than in climbing stairs (difference up stairs – level: -8.1°, p = 0.018). The AOFAS Scale improved significantly from 56.9 ± 19.9 points (mean ± SD), preoperatively, to 75.9 ± 13.9 points, postoperatively (p = 0.027). CONCLUSIONS: Cheilectomy is appropriate for reducing symptoms of hallux rigidus. However, neither a positive influence on the range of motion in walking on level ground and on stairs nor a functional improvement was observed in this group of patients. TRIAL REGISTRATION: NCT01804491