Efficacy, Indications and Limitations of Hallux Arthroscopy

OBJECTIVE: First metatarsophalangeal joint arthroscopy is a realative new technique including particulars as sinovitis, osteochondral lesions, incipient degenerative arthropathies and loose bodies. The aim of this study was to define the indications, effectiveness and limitations of this procedure. MATERIAL AND METHOD: 16 patients were operated. The procedure was carried out through three dorsomedial, dorsolateral and medial portals. Indications were osteochondral lesions of the metatarsal head (N=8), osteochondral lesion of the proximal phalanx of the hallux (N=1), loose bodies (N=1), sinovitis (N=2) and early degenerative joint disease with dorsal osteophytosis of the first metatarsal head (N=4). RESULTS: Monitoring of the patients was a minimum of two years. The clinical and radiological assesment were performed by the same team of surgeons. 87,5% of patients had complete remission of the symptomatology five months after surgery (N=14). Good functional but not complete remission of the symptomatology outcomes were detected in a patient with hallux rigidus (HR) Gl and another patient with (HR) Gll. There were no complications with this technique. DISCUSSION: In osteochondral lesions, loose bodies and sinovitis, hallux arthroscopy has good outcomes without complications; but minor findings in patients with arthrosis degenerative changes and osteophytes (Hallux Rigidus). These patients requiere other tecniques such cheilectomy, osteotomies and arthrodesis in degenerative extensive injuries.