Hallux rigidus : perspectives contemporaines
Seance of wednesday 22 october 2025 (L'Académie reçoit l'Association Française de la Chirurgie du Pied (AFCP))
DOI number : 10.26299/q663-h468/emem.2025.43.04
Abstract
Hallux rigidus, or first metatarsophalangeal (MTP1) joint osteoarthritis, is the most common degenerative disorder of the foot. Its management has significantly evolved in recent years thanks to the work of the AFCP and the development of a decision-making algorithm published in 2022. MTP1 osteoarthritis is characterized by a vicious cycle of inflammation and degeneration, with progressive involvement of cartilage, subchondral bone, capsule, and ligaments, making treatment complex. Clinical manifestations may include pain, stiffness, and deformities such as hallux valgus or functional hallux limitus.
Existing classifications to assess disease stage remain multiple and imperfect. The causes are varied: mechanical (long first metatarsal, metatarsus elevatus), metabolic, post-traumatic, or degenerative.
Therapeutic strategies are now shifting toward more conservative options: medical management, joint-preserving surgical techniques (cheilectomy, osteotomy, arthroscopy, minimally invasive surgery). Arthrodesis, long considered the gold standard, is increasingly reserved for the most severe or disabling cases.
In conclusion, hallux rigidus cannot be reduced to a simple loss of mobility: it is a multifactorial condition, sometimes painless, for which current management emphasizes functional preservation and individualized treatment strategies.
Existing classifications to assess disease stage remain multiple and imperfect. The causes are varied: mechanical (long first metatarsal, metatarsus elevatus), metabolic, post-traumatic, or degenerative.
Therapeutic strategies are now shifting toward more conservative options: medical management, joint-preserving surgical techniques (cheilectomy, osteotomy, arthroscopy, minimally invasive surgery). Arthrodesis, long considered the gold standard, is increasingly reserved for the most severe or disabling cases.
In conclusion, hallux rigidus cannot be reduced to a simple loss of mobility: it is a multifactorial condition, sometimes painless, for which current management emphasizes functional preservation and individualized treatment strategies.