MANIPULATION UNDER ANAESTHESIA AND INJECTION FOR HALLUX RIGIDUS - DOES IT WORK?

Abstract

Hallux rigidus is the second most common pathological condition of the first metatarsophalangeal joint, after hallux valgus. Manipulation of the joint and injection with steroid and local anaesthetic (MUA and Injection) is widely practiced, but the literature contains little information on the results of such treatment. We report the results of this procedure performed on thirty-seven joints, with a minimum follow-up of 1 year (mean 41.2 months). Patients with mild (Grade I) changes gained symptomatic relief for a mean of 6 months and only one third required further surgery. Two thirds of patients with moderate (Grade II) disease proceeded to open surgery. In advanced (Grade III) hallux rigidus little symptomatic relief was obtained and all patients required operative treatment. We recommend that joints are Graded before treatment and that MUA and injection be used only in early (Grades I and II) hallux rigidus.