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.