Surgical approaches to hallux rigidus: a systematic review of arthrodesis and alternative techniques

Abstract

Objective: To analyze and compare the clinical outcomes of arthrodesis versus alternative surgical techniques for hallux rigidus in adults. Methods: A systematic literature review was conducted in accordance with PRISMA guidelines. Electronic searches were performed in major databases to identify studies reporting surgical outcomes of arthrodesis and alternative techniques for hallux rigidus. Study characteristics, surgical techniques, reported outcomes, and complications were qualitatively synthesized. Results: The included studies were predominantly retrospective and demonstrated substantial heterogeneity in surgical techniques, outcome measures, and follow-up durations. Reported outcomes varied widely across procedures, and direct comparative evidence was limited. Conclusions: Current evidence on the surgical management of hallux rigidus is limited by study design, heterogeneity, and risk of bias. The available literature does not allow definitive conclusions regarding the superiority or equivalence of arthrodesis and motionpreserving procedures. High-quality comparative studies are needed to better define the role of alternative techniques in the treatment of hallux rigidus. Level of Evidence III; Systematic Review.