Intermediate Learning Pathway: Hallux Limitus/Rigidus - Etiology, Treatment and Complications

Learning Objectives of this Pathway:

• Understand workup and treatment of hallux limitus/rigidus
• Understand the different surgical options including joint sparing and joint destructive procedures
• Understand the techniques of 1^stMPJ arthrodesis
• Understand the techniques of 1^stMPJ implant arthroplasty

Download a PDF of this learning pathway

Day 1:

Podcasts:

• Hallux Limitus
• Hallux Rigidus

JFAS Journal Full Collection Articles:
https://www.jfas.org/content/halluxlimitus

Day 2:

Clinical Sessions (individual):

• Stage 2 Hallux Rigidus: Cheilectomy vs. Decompressive Osteotomy
• Stage 2 Hallux Rigidus: Cheilectomy vs. Decompressive Osteotomy - Decompression Osteotomy for Stage 2 Hallux Rigidus

JFAS Articles:

• Rate of Revision After Cheilectomy Versus Decompression Osteotomy in Early-Stage Hallux Rigidus
• Long-Term Follow-Up of the Cheilectomy for Degenerative Joint Disease of the First Metatarsophalangeal Joint
• Mechanical Comparison of the Youngswick, Sagittal V, and Modified Weil Osteotomies for Hallux Rigidus in a Sawbone Model

Clinical Sessions (individual):

• Stage 3 Hallux Rigidus: 1st MPJ Arthrodesis vs. Implant Arthroplasty - Implant Arthroplasty vs Arthrodesis Forefoot Case Controversies
• Stage 3 Hallux Rigidus: 1st MPJ Arthrodesis vs. Implant Arthroplasty - 1st MPJ Arthrodesis

JFAS Journal Article:
Does Total Joint Replacement or Arthrodesis of the First Metatarsophalangeal Joint Yield Better Functional Results? A Systematic Review of the Literature

Podcast:
Deciphering 1st MPJ Implants

Day 3:

Clinical Sessions (full course):
1st MTPJ Arthrodesis: Common Practices, Overlooked Details

Podcasts:
Great Toe Fusion

Additional Outside Journal References

• Fundamentals of joint injection.Rastogi, A. K., Davis, K. W., Ross, A., & Rosas, H. G. (2016).
  American Journal of Roentgenology, 207(3), 484–494.
• Intra-articular corticosteroid injections: A critical literature review with up-to-date findings.
  Pekarek, B., Osher, L., Buck, S., & Bowen, M. (2011). Foot.
• New Technology in the Treatment of Hallux Rigidus with a Synthetic Cartilage Implant Hemiarthroplasty.
  Baumhauer, J. F., Daniels, T., & Glazebrook, M. (2019). Orthopedic Clinics of North America.
• Hallux Rigidus. Grading and Long-Term Results of Operative Treatment.
  Coughlin, M. J., & Shurnas, P. S. (2003).Journal of Bone and Joint Surgery - Series A.
• Early Outcomes and Complications of Synthetic Cartilage Implant for Treatment of Hallux Rigidus in the United States.
  Cassinelli SJ, Chen S, Charlton TP, Thordarson DB. Foot Ankle Int. 2019 Oct;40(10):1140-1148. doi: 10.1177/1071100719855049. Epub 2019 Jun 13.
• Response to "Letter Regarding: Early Outcomes and Complications of Synthetic Cartilage Implant for Treatment of Hallux Rigidus in the United States".
  Thordarson DB, Cassinelli SJ, Charlton TP, Chen S. Foot Ankle Int. 2019 Oct;40(10):1152-1153. doi: 10.1177/1071100719878413. No abstract available.
• Radiographic and Magnetic Resonance Imaging of the Symptomatic Synthetic Cartilage Implant.
  An TW, Cassinelli S, Charlton TP, Pfeffer GB, Thordarson DB. Foot Ankle Int. 2020 Jan;41(1):25-30. doi: 10.1177/1071100719877147. Epub 2019 Sep 20.
• Letter Regarding: Early Outcomes and Complications of Synthetic Cartilage Implant for Treatment of Hallux Rigidus in the United States.
  Glazebrook M, Baumhauer JF, Blundell C, De Vries G, Le ILD, Nielsen D, Sakellariou A, Solan M, Wansbrough G, Younger ASE, Daniels T. Foot Ankle Int. 2019 Oct;40(10):1149-1151. doi: 10.1177/1071100719878414. No abstract available.

The ACFAS learning pathways are a tool to be used by residency directors, fellowship directors and school faculty to aid with didactic learning during the COVID-19 crisis. They are not intended to replace a curriculum, but to supplement student and resident education during this time of need. The learning pathways are divided into basic, intermediate, and advanced categories. Pathways have been organized into specific topics that have a variety of educational materials from the ACFAS On Demand course content. They also include journal articles with links primarily from The Journal of Foot & Ankle Surgery (JFAS).