BACKGROUND First metatarsophalangeal joint arthritis(FMTPA),also known as hallux rigidus,is the most frequent degenerative disease of the foot.Diagnosis is made through both clinical and radiological evaluation.Regene...BACKGROUND First metatarsophalangeal joint arthritis(FMTPA),also known as hallux rigidus,is the most frequent degenerative disease of the foot.Diagnosis is made through both clinical and radiological evaluation.Regenerative medicine showed promising results in the treatment of early osteoarthritis.The aim of the present study was to report the results of a case of FMTPA treated with the injection of autologous adipose-derived mesenchymal stem cells.CASE SUMMARY A gentleman of 50 years of age presented with a painful hallux rigidus grade 2 resistant to any previous conservative treatment(including nonsteroidal antiinflammatory drugs and hyaluronic acid injections).An injection of autologous adipose-derived mesenchymal stem cells into the first metatarsophalangeal joint was performed.No adverse events were reported,and both function and pain scales improved after 9 mo of follow-up.CONCLUSION The FMTP joint injection of mesenchymal stem cells improved symptoms and function in our patient with FMTPA at 9 mo of follow-up.展开更多
Hallux rigidus is a degenerative disease of the first metatarsalphalangeal(MTP) joint and affects 2.5% of people over age 50. Dorsal osteophytes and narrowed joint space leads to debilitating pain and limited range of...Hallux rigidus is a degenerative disease of the first metatarsalphalangeal(MTP) joint and affects 2.5% of people over age 50. Dorsal osteophytes and narrowed joint space leads to debilitating pain and limited range of motion. Altered gait mechanics often ensued as 119% of the body force transmit through the 1^(st) MTP joint during gait cycle. Precise etiology remains under debate with trauma being often cited in the literature. Hallux valgus interphalangeus, female gender, inflammatory and metabolic conditions have all been identified as associative factors. Clinical symptoms, physical exam and radiographic evidence are important in assessing and grading the disease. Non-operative managements including nonsteroidal antiinflammatory drugs, intraarticular injections, shoe modification, activity modification and physical therapy, should always be attempted for all hallux rigidus patients. The goal of surgery is to relieve pain, maintain stability of the first MTP joint, and improve function and quality of life. Operative treatments can be divided into joint-sparing vs joint-sacrificing. Cheilectomy and moberg osteotomy are examples of joint-sparing techniques that have demonstrated great success in early stages of hallux rigidus. Arthrodesis is a joint-sacrificing procedure that has been the gold standard for advanced hallux rigidus. Other newer procedures such as implant arthroplasty, interpositional arthroplasty and arthroscopy, have demonstrated promising early patient outcomes. However, future studies are still needed to validate its long-term efficacy and safety. The choice of procedure should be based on the condition of the joint, patient's goal and expectations, and surgeon's experience with the technique.展开更多
Hallux rigidus describes the osteoarthritis of the firstmetatarsophalangeal joint. It was first mentioned in 1887. Since then a multitude of terms have been introduced referring to the same disease. The main complaint...Hallux rigidus describes the osteoarthritis of the firstmetatarsophalangeal joint. It was first mentioned in 1887. Since then a multitude of terms have been introduced referring to the same disease. The main complaints are pain especially during movement and a limited range of motion. Radiographically the typical signs of osteoarthritis can be observed starting at the dorsal portion of the joint. Numerous classifications make the comparison of the different studies difficult. If non-operative treatment fails to resolve the symptoms operative treatment is indicated. The most studied procedure with reproducible results is the arthrodesis. Nevertheless, many patients refuse this treatment option, favouring a procedure preserving motion. Different motion preserving and joint sacrificing operations such as arthroplasty are available. In this review we focus on motion and joint preserving procedures. Numer-ous joint preserving osteotomies have been described. Most of them try to relocate the viable plantar cartilage more dorsally, to decompress the joint and to increase dorsiflexion of the first metatarsal bone. Multiple studies are available investigating these procedures. Most of them suffer from low quality, short follow up and small patient numbers. Consequently the grade of recommendation is low. Nonetheless, joint preserving procedures are appealing because if they fail to relief the symptoms an arthrodesis or arthroplasty can still be performed thereafter.展开更多
Volatile components of Callistemon rigidus were analyzed by headspace solid phase microextraction-gas chromatography/mass spectrometry.The results showed that 34 volatile components,including alkenes,esters,alcohols,a...Volatile components of Callistemon rigidus were analyzed by headspace solid phase microextraction-gas chromatography/mass spectrometry.The results showed that 34 volatile components,including alkenes,esters,alcohols,and a small amount of acids,heterocycles and alkanes,were identified from C.rigidus flowers.The main components were eucalyptol,aspidinol,terpilenol,vanillylacetone,α-phellandrene,4-pyran-4-1,2,3-dihydro-3,5-dihydroxy-6-methyl,pinene,3-methylcatechol,naphthalene,(+)-limonene,7-methylxanthine and (+)-aromadendrene,the contents of which were 35.39%,10.09%,8.86%,4.51%,3.25%,2.81%,2.75%,2.43%,2.29%,1.3%,1.12% and 1.07%,respectively,all of which accounted for 75.69% of the total relative content.Monoterpenoids are the main components of various types of essential oils.This study provides a theoretical basis for the deep processing of this variety.展开更多
BACKGROUND Cheilectomy of the 1^(st)metatarsophalangeal joint(MTPJ)is one of the most common procedures for the management of hallux rigidus.However,there is no consensus regarding outcomes following minimally invasiv...BACKGROUND Cheilectomy of the 1^(st)metatarsophalangeal joint(MTPJ)is one of the most common procedures for the management of hallux rigidus.However,there is no consensus regarding outcomes following minimally invasive dorsal cheilectomy(MIDC)for the management of hallux rigidus.AIM To evaluate outcomes following MIDC for the management of hallux rigidus.METHODS During November 2023,the PubMed,EMBASE and Cochrane Library databases were systematically reviewed to identify clinical studies examining outcomes following MIDC for the management of hallux rigidus.RESULTS Six studies were included.In total,348 patients(370 feet)underwent MIDC for hallux rigidus at a weighted mean follow-up of 37.9±16.5 months.The distribution of patients by Coughlin and Shurna's classification was recorded in 4 studies as follows:Ⅰ(58 patients,27.1%),Ⅱ(112 patients,52.3%),Ⅲ(44 patients,20.6%).Three studies performed an additional 1^(st)MTPJ arthroscopy and debridement following MIDC.Retained intra-articular bone debris was observed in 100%of patients in 1 study.The weighted mean American orthopedic foot and ankle society score improved from a preoperative score of 68.9±3.2 to a postoperative score of 87.1.The complication rate was 8.4%,the most common of which was persistent joint pain and stiffness.Thirty-two failures(8.7%)were observed.Thirty-three secondary procedures(8.9%)were performed at a weighted mean time of 8.6±3.2 months following the index procedure.CONCLUSION This systematic review demonstrated improvements in subjective clinical outcomes together with a moderate complication rate following MIDC for the management of hallux rigidus at short-term follow-up.A moderate reoperation rate at short-term follow-up was recorded.The marked heterogeneity between included studies and paucity of high quality comparative studies limits the generation of any robust conclusions.展开更多
Hallux rigidus occurs mainly at the first metatarsophalangeal （MTP） joint,causing localized pain and degenerative arthritis.1 This condition frequently occurs together with hallux valgus and is difficult to treat.Fo...Hallux rigidus occurs mainly at the first metatarsophalangeal （MTP） joint,causing localized pain and degenerative arthritis.1 This condition frequently occurs together with hallux valgus and is difficult to treat.For hallux rigidus affecting only one joint,the treatment choices include articular debridement,resection arthroplasty,prosthetic arthroplasty,and arthrodesis,depending on the degree of arthritis.展开更多
The first metatarsophalangeal(MTP)joint plays a crucial role in foot biomechanics,particularly in weight-bearing activities such as walking and running.It is frequently affected by conditions like hallux valgus(HV)and...The first metatarsophalangeal(MTP)joint plays a crucial role in foot biomechanics,particularly in weight-bearing activities such as walking and running.It is frequently affected by conditions like hallux valgus(HV)and hallux rigidus,with HV impacting approximately 23%-35% of the population.This narrative review explores the embryology,anatomy,and biomechanics of the first MTP joint(MTPJ),highlighting its significance in maintaining foot stability and function.A comprehensive literature search was conducted using PubMed,Scopus,and Google Scholar,analyzing 50 relevant studies,including 12 clinical trials.The joint’s complex structure and mechanical demands make it susceptible to degenerative and structural disorders.Studies indicate that 25%-40%of individuals with HV experience significant pain and functional impairment,affecting mobility and quality of life.Biomechanical stress,abnormal gait patterns,and joint instability contribute to disease progression.Understanding the anatomical and biomechanical properties of the first MTPJ is essential for improving diagnostic and therapeutic approaches.Emerging surgical techniques,such as osteotomy and joint resurfacing,show promise in reducing recurrence rates and enhancing longterm outcomes.Further research is needed to refine minimally invasive interventions and optimize treatment strategies for first MTPJ disorders.展开更多
First metatarsophalangeal joint （MTPJ） degenerative diseases are not rare pathological changes in adult forefoot.1,2 It mainly includes hallux rigidus,hallux limitus and hallux valgus.3 Its progressive nature makes ...First metatarsophalangeal joint （MTPJ） degenerative diseases are not rare pathological changes in adult forefoot.1,2 It mainly includes hallux rigidus,hallux limitus and hallux valgus.3 Its progressive nature makes it hardly respond well to conservative treatment.4 Traditional surgical techniques,such as cheilectomy,Keller resection and arthrodesis are effective procedures but remain controversial due to none of them can achieve excellent results in all patients especially the end-stage conditions.5-7 Thus,great amount of efforts have been dedicated in MTPJ replacement despite many negative reports.This technique has aroused many controversies over the past decades due to its prematurity.Nevertheless,it has been improved in many aspects such as prosthesis material,design as well as surgical indications.This review would not only update the advancements and recognitions in recent years,but also presented the major disputed areas.展开更多
文摘BACKGROUND First metatarsophalangeal joint arthritis(FMTPA),also known as hallux rigidus,is the most frequent degenerative disease of the foot.Diagnosis is made through both clinical and radiological evaluation.Regenerative medicine showed promising results in the treatment of early osteoarthritis.The aim of the present study was to report the results of a case of FMTPA treated with the injection of autologous adipose-derived mesenchymal stem cells.CASE SUMMARY A gentleman of 50 years of age presented with a painful hallux rigidus grade 2 resistant to any previous conservative treatment(including nonsteroidal antiinflammatory drugs and hyaluronic acid injections).An injection of autologous adipose-derived mesenchymal stem cells into the first metatarsophalangeal joint was performed.No adverse events were reported,and both function and pain scales improved after 9 mo of follow-up.CONCLUSION The FMTP joint injection of mesenchymal stem cells improved symptoms and function in our patient with FMTPA at 9 mo of follow-up.
文摘Hallux rigidus is a degenerative disease of the first metatarsalphalangeal(MTP) joint and affects 2.5% of people over age 50. Dorsal osteophytes and narrowed joint space leads to debilitating pain and limited range of motion. Altered gait mechanics often ensued as 119% of the body force transmit through the 1^(st) MTP joint during gait cycle. Precise etiology remains under debate with trauma being often cited in the literature. Hallux valgus interphalangeus, female gender, inflammatory and metabolic conditions have all been identified as associative factors. Clinical symptoms, physical exam and radiographic evidence are important in assessing and grading the disease. Non-operative managements including nonsteroidal antiinflammatory drugs, intraarticular injections, shoe modification, activity modification and physical therapy, should always be attempted for all hallux rigidus patients. The goal of surgery is to relieve pain, maintain stability of the first MTP joint, and improve function and quality of life. Operative treatments can be divided into joint-sparing vs joint-sacrificing. Cheilectomy and moberg osteotomy are examples of joint-sparing techniques that have demonstrated great success in early stages of hallux rigidus. Arthrodesis is a joint-sacrificing procedure that has been the gold standard for advanced hallux rigidus. Other newer procedures such as implant arthroplasty, interpositional arthroplasty and arthroscopy, have demonstrated promising early patient outcomes. However, future studies are still needed to validate its long-term efficacy and safety. The choice of procedure should be based on the condition of the joint, patient's goal and expectations, and surgeon's experience with the technique.
文摘Hallux rigidus describes the osteoarthritis of the firstmetatarsophalangeal joint. It was first mentioned in 1887. Since then a multitude of terms have been introduced referring to the same disease. The main complaints are pain especially during movement and a limited range of motion. Radiographically the typical signs of osteoarthritis can be observed starting at the dorsal portion of the joint. Numerous classifications make the comparison of the different studies difficult. If non-operative treatment fails to resolve the symptoms operative treatment is indicated. The most studied procedure with reproducible results is the arthrodesis. Nevertheless, many patients refuse this treatment option, favouring a procedure preserving motion. Different motion preserving and joint sacrificing operations such as arthroplasty are available. In this review we focus on motion and joint preserving procedures. Numer-ous joint preserving osteotomies have been described. Most of them try to relocate the viable plantar cartilage more dorsally, to decompress the joint and to increase dorsiflexion of the first metatarsal bone. Multiple studies are available investigating these procedures. Most of them suffer from low quality, short follow up and small patient numbers. Consequently the grade of recommendation is low. Nonetheless, joint preserving procedures are appealing because if they fail to relief the symptoms an arthrodesis or arthroplasty can still be performed thereafter.
文摘Volatile components of Callistemon rigidus were analyzed by headspace solid phase microextraction-gas chromatography/mass spectrometry.The results showed that 34 volatile components,including alkenes,esters,alcohols,and a small amount of acids,heterocycles and alkanes,were identified from C.rigidus flowers.The main components were eucalyptol,aspidinol,terpilenol,vanillylacetone,α-phellandrene,4-pyran-4-1,2,3-dihydro-3,5-dihydroxy-6-methyl,pinene,3-methylcatechol,naphthalene,(+)-limonene,7-methylxanthine and (+)-aromadendrene,the contents of which were 35.39%,10.09%,8.86%,4.51%,3.25%,2.81%,2.75%,2.43%,2.29%,1.3%,1.12% and 1.07%,respectively,all of which accounted for 75.69% of the total relative content.Monoterpenoids are the main components of various types of essential oils.This study provides a theoretical basis for the deep processing of this variety.
文摘BACKGROUND Cheilectomy of the 1^(st)metatarsophalangeal joint(MTPJ)is one of the most common procedures for the management of hallux rigidus.However,there is no consensus regarding outcomes following minimally invasive dorsal cheilectomy(MIDC)for the management of hallux rigidus.AIM To evaluate outcomes following MIDC for the management of hallux rigidus.METHODS During November 2023,the PubMed,EMBASE and Cochrane Library databases were systematically reviewed to identify clinical studies examining outcomes following MIDC for the management of hallux rigidus.RESULTS Six studies were included.In total,348 patients(370 feet)underwent MIDC for hallux rigidus at a weighted mean follow-up of 37.9±16.5 months.The distribution of patients by Coughlin and Shurna's classification was recorded in 4 studies as follows:Ⅰ(58 patients,27.1%),Ⅱ(112 patients,52.3%),Ⅲ(44 patients,20.6%).Three studies performed an additional 1^(st)MTPJ arthroscopy and debridement following MIDC.Retained intra-articular bone debris was observed in 100%of patients in 1 study.The weighted mean American orthopedic foot and ankle society score improved from a preoperative score of 68.9±3.2 to a postoperative score of 87.1.The complication rate was 8.4%,the most common of which was persistent joint pain and stiffness.Thirty-two failures(8.7%)were observed.Thirty-three secondary procedures(8.9%)were performed at a weighted mean time of 8.6±3.2 months following the index procedure.CONCLUSION This systematic review demonstrated improvements in subjective clinical outcomes together with a moderate complication rate following MIDC for the management of hallux rigidus at short-term follow-up.A moderate reoperation rate at short-term follow-up was recorded.The marked heterogeneity between included studies and paucity of high quality comparative studies limits the generation of any robust conclusions.
文摘Hallux rigidus occurs mainly at the first metatarsophalangeal （MTP） joint,causing localized pain and degenerative arthritis.1 This condition frequently occurs together with hallux valgus and is difficult to treat.For hallux rigidus affecting only one joint,the treatment choices include articular debridement,resection arthroplasty,prosthetic arthroplasty,and arthrodesis,depending on the degree of arthritis.
文摘The first metatarsophalangeal(MTP)joint plays a crucial role in foot biomechanics,particularly in weight-bearing activities such as walking and running.It is frequently affected by conditions like hallux valgus(HV)and hallux rigidus,with HV impacting approximately 23%-35% of the population.This narrative review explores the embryology,anatomy,and biomechanics of the first MTP joint(MTPJ),highlighting its significance in maintaining foot stability and function.A comprehensive literature search was conducted using PubMed,Scopus,and Google Scholar,analyzing 50 relevant studies,including 12 clinical trials.The joint’s complex structure and mechanical demands make it susceptible to degenerative and structural disorders.Studies indicate that 25%-40%of individuals with HV experience significant pain and functional impairment,affecting mobility and quality of life.Biomechanical stress,abnormal gait patterns,and joint instability contribute to disease progression.Understanding the anatomical and biomechanical properties of the first MTPJ is essential for improving diagnostic and therapeutic approaches.Emerging surgical techniques,such as osteotomy and joint resurfacing,show promise in reducing recurrence rates and enhancing longterm outcomes.Further research is needed to refine minimally invasive interventions and optimize treatment strategies for first MTPJ disorders.
文摘First metatarsophalangeal joint （MTPJ） degenerative diseases are not rare pathological changes in adult forefoot.1,2 It mainly includes hallux rigidus,hallux limitus and hallux valgus.3 Its progressive nature makes it hardly respond well to conservative treatment.4 Traditional surgical techniques,such as cheilectomy,Keller resection and arthrodesis are effective procedures but remain controversial due to none of them can achieve excellent results in all patients especially the end-stage conditions.5-7 Thus,great amount of efforts have been dedicated in MTPJ replacement despite many negative reports.This technique has aroused many controversies over the past decades due to its prematurity.Nevertheless,it has been improved in many aspects such as prosthesis material,design as well as surgical indications.This review would not only update the advancements and recognitions in recent years,but also presented the major disputed areas.
