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dc.contributor.authorCoutts, A.
dc.contributor.authorKilmartin, T. E.
dc.contributor.authorEllis, Mairghread JH
dc.date.accessioned2018-06-29T21:48:48Z
dc.date.available2018-06-29T21:48:48Z
dc.date.issued2012-09
dc.identifierER2767
dc.identifier.citationCoutts, A., Kilmartin, T. & Ellis, M. (2012) The long-term patient focused outcomes of the Keller's arthroplasty for the treatment of hallux rigidus, Foot, vol. 22, , pp. 167-171,
dc.identifier.issn0958-2592
dc.identifier.urihttp://dx.doi.org/10.1016/j.foot.2012.02.008
dc.identifier.urihttps://eresearch.qmu.ac.uk/handle/20.500.12289/2767
dc.description.abstractBackground: The Keller arthroplasty has been used to treat painful conditions of the first MTP joint for over 100 years. More recently the procedure has fallen out of favour, due to a high incidence of transfer metatarsalgia and poor function of the first MTP joint post-operatively. Objective: This study sought to review the place for Keller arthroplasty in the management of hallux rigidus by considering outcomes from the patient's perspective. Methods: From 1997 to 2005, 104 patients (131 feet) underwent a Keller excisional arthroplasty for the treatment of hallux rigidus. All subjects were classed as grade III on the Hattrup and Johnson scale of joint classification and had a primary complaint of painful hallux rigidus. The American orthopaedic foot and ankle scale was applied pre-operatively and post-operatively. Thirty-two participants (42 feet) were available for a final review (6 male feet and 34 female feet). The range of follow up was 36-154 months with a mean average follow up of 92 months (7.6 years). The age range at the time of surgery was 42-78 years with a mean average age of 62 years at surgery and 69 years and eight months at review. Results: Seventy-six percent of participants were completely satisfied, 21.5% satisfied with reservations and 2.5% were dissatisfied. High levels of satisfaction were recorded for pain relief, activity levels and overall patient satisfaction. Ninety-five percent of participants reported their symptoms were improved at long-term follow up compared to pre operatively; however 9.5% of the group complained of transfer metatarsalgia. Nineteen percent of participants, all female, were not happy with the cosmetic appearance of their foot. The mean pre-operative AOFAS clinical rating scale scores was 38. At final follow up the mean score was 89. Conclusion: The Keller excisional arthroplasty is a simple reliable procedure for the treatment of severe hallux rigidus. Furthermore, it is effective in achieving pain-free movement of the first MTP joint, but carries a risk of creating transfer metatarsalgia. For nearly 20% of participants post-operative cosmetic appearance was disappointing. 2012 Elsevier Ltd. All rights reserved
dc.format.extent167-171
dc.relation.ispartofFoot
dc.titleThe long-term patient focused outcomes of the Keller's arthroplasty for the treatment of hallux rigidus
dc.typearticle
dcterms.accessRightsrestricted
dc.description.facultysch_pod
dc.description.volume22
dc.description.ispublishedpub
dc.description.eprintid2767
rioxxterms.typearticle
qmu.authorEllis, Mairghread JH
dc.description.statuspub
dc.description.number3


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