Evaluation of Clinical Outcomes After Cheilectomy and Microfracture in Hallux Rigidus

Hallux rigidus (HR) is a common form of osteoarthritis that affects the first metatarsophalangeal joint, causing pain, stiffness, and functional limitations. Cheilectomy, a joint-preserving surgical method, is often used in early to mid-stage HR. Microfracture is a cartilage repair technique that stimulates fibrocartilage formation. This retrospective study evaluated and compared the clinical outcomes of 62 patients who underwent cheilectomy alone (Group 1, n=32) or cheilectomy combined with microfracture (Group 2, n=30) between January 2019 and September 2023. The mean follow-up duration was 25.8 ± 7.2 months (range, 18–40 months) in Group 1 and 23.1 ± 7.3 months (range, 16–42 months) in Group 2. Functional outcomes were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) score, Visual Analog Scale (VAS) for pain, and dorsiflexion (DF) angles. Both groups demonstrated statistically significant improvements in all parameters postoperatively (p<0.001), while the AOFAS scores were significantly higher in the combined microfracture group (p=0.0168). No significant differences were observed in VAS and DF angle values between the groups. These findings suggest that the addition of microfracture to cheilectomy may enhance short- to mid-term functional outcomes without increasing complications. Further prospective, long-term studies are required to confirm its sustained effectiveness and potential benefits in the treatment of hallux rigidus.