{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T17:27:55Z","timestamp":1793726875064,"version":"4.6.1"},"reference-count":57,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2020,5,21]],"date-time":"2020-05-21T00:00:00Z","timestamp":1590019200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Foot Ankle Int."],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Several operative interventions are available to alleviate pain in hallux rigidus, and the optimal operative technique is still a topic of debate among surgeons. Three of these are arthrodesis, cheilectomy, and Keller\u2019s arthroplasty. Currently, it is unclear which intervention yields the best long-term result. The aim of this study was to assess which of these interventions performed best in terms of patient-reported outcome, pain scores, and disease recurrence at long-term follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>These data are the follow-up to the initial study published in 2006. In the original study, 73 patients (n = 89 toes) with symptomatic hallux rigidus were recruited and underwent first metatarsophalangeal joint arthrodesis (n = 33 toes), cheilectomy (n = 28 toes), or Keller\u2019s arthroplasty (n = 28 toes). Outcome measures were AOFAS hallux metatarsophalangeal-interphalangeal (HMI) score, and pain was assessed with a visual analog scale (VAS) at a mean follow-up period of 7 years. Patients of the original study were identified and invited to participate in the current study. Data were collected in the form of AOFAS-HMI score, VAS pain score, Manchester-Oxford Foot Questionnaire (MOXFQ), and Forgotten Joint Score (FJS-12). In addition, a clinical examination was performed and radiographs were obtained. Data were available for 37 patients (45 toes), with a mean follow-up period over 22 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>AOFAS-HMI and VAS pain score improved during follow-up only in arthrodesis patients. Furthermore, no statistically significant differences in clinical and patient-reported outcome were detected between groups based on AOFAS-HMI, VAS pain, MOXFQ, or FJS-12. However, clinically important differences in patient-reported outcomes and pain scores were detected, favoring arthrodesis. Radiographic disease progression was more evident after cheilectomy compared with Keller\u2019s arthroplasty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Arthrodesis, cheilectomy, and Keller\u2019s arthroplasty are 3 sucessful operative interventions to treat symptomatic hallux rigidus. Because clinically important differences were detected and symptoms still diminish many years after surgery, a slight preference was evident for arthrodesis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>Level III, comparative study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1071100720919681","type":"journal-article","created":{"date-parts":[[2020,5,21]],"date-time":"2020-05-21T09:26:53Z","timestamp":1590053213000},"page":"775-783","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":21,"title":["Long-term Effects of Cheilectomy, Keller\u2019s Arthroplasty, and Arthrodesis for Symptomatic Hallux Rigidus on Patient-Reported and Radiologic Outcome"],"prefix":"10.1177","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8869-9703","authenticated-orcid":false,"given":"Jasper","family":"Stevens","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, Zuyderland Medical Centre, Sittard-Geleen-Heerlen, the Netherlands"},{"name":"Department of Orthopaedics, Maastricht University Medical Centre, Maastricht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin T.A.L.","family":"de Bot","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Zuyderland Medical Centre, Sittard-Geleen-Heerlen, the Netherlands"},{"name":"Department of Orthopaedics, Maastricht University Medical Centre, Maastricht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adhiambo M.","family":"Witlox","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Maastricht University Medical Centre, Maastricht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rob","family":"Borghans","sequence":"additional","affiliation":[{"name":"Department of Radiology, Zuyderland Medical Centre, Sittard-Geleen-Heerlen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thijs","family":"Smeets","sequence":"additional","affiliation":[{"name":"Smeets Loopcomfort, Sittard, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wieske","family":"Beertema","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Zuyderland Medical Centre, Sittard-Geleen-Heerlen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roel P.","family":"Hendrickx","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Zuyderland Medical Centre, Sittard-Geleen-Heerlen, the 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