PMC9512608_01
Preoperative right foot anteroposterior radiograph taken at the time of presentation.
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Preoperative right foot lateral radiograph taken at the time of presentation showing prior dorsal cheilectomy.
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Preoperative right foot MRI performed 14-month status postdorsal cheilectomy demonstrating 50% loss of the first metatarsal head.
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Also noted was 50% surface area loss of the first metatarsal head (Figure 3). Demonstration of the graft with the metatarsal head also showed restored stability, as compared to preoperative MRI findings, which originally revealed joint instability with volar subluxation of the metatarsal head and dorsal subluxation of the proximal phalanx due to the lack of a dorsal metatarsal head (Figure 3).
Dorsomedial incision of the first MTP joint shows Outerbridge classification grade IV chondromalacia with 50% of metatarsal head cartilage missing.
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A standard incision was made over the dorsomedial aspect of the first MTP joint (Figure 4).
Fresh talonavicular joint cartilage implant increased dorsiflexion and plantarflexion by 20 degrees during the operation.
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The dorsal aspect of the graft was secured to the remaining metatarsal with excellent stability (Figure 5).
Postoperative lateral radiograph of the right foot demonstrating hallux rigidus correction with OCA implantation on the metatarsal head.
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Postoperative radiographs taken at three month follow-up revealed correction of the hallux rigidus and osteochondral lesion with no fractures or dislocations (Figures 6 and 7).
Postoperative oblique radiograph of the right foot demonstrating hallux rigidus correction with OCA implantation on the metatarsal head.
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Postoperative radiographs taken at three month follow-up revealed correction of the hallux rigidus and osteochondral lesion with no fractures or dislocations (Figures 6 and 7).
Anteroposterior radiograph of the right foot taken three years post-OCA implantation with complete resolution of hallux rigidus.
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Radiographs taken at that time revealed complete resolution of hallux rigidus (Figures 8-10).
Lateral radiograph of the right foot taken three years post-OCA implantation with complete resolution of hallux rigidus.
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Radiographs taken at that time revealed complete resolution of hallux rigidus (Figures 8-10).
Oblique radiograph of the right foot taken three years post-OCA implantation with complete resolution of hallux rigidus.
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Radiographs taken at that time revealed complete resolution of hallux rigidus (Figures 8-10).