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 degrees, 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.