Incidence and Impact of the Presence of Tarsometatarsal Joint Arthritis in Patients with Hallux Rigidus: A Retrospective Radiographic Study

Osteoarthritis is a common condition frequently found throughout various joints in the foot and ankle, including the tarsometatarsal joints (TMTJ) and the first metatarsophalangeal joint (MTPJ). It has been well established that the presence of arthritis and decreased motion in a joint often results in increased stress to the joints immediately distal and proximal. The primary aim of this study was to evaluate the incidence and impact of the presence of TMTJ arthritis in patients with symptomatic end-stage osteoarthritis of the first MTPJ, commonly referred to as hallux rigidus (HR). Retrospective radiographic review was performed on 138 patients with HR. TMTJ arthritis was identified in 27 of 138 (19.6%) of patients with HR, most commonly at the second TMTJ (25/27). Additionally, 30 of 138 (21.7%) patients eventually pursued surgical intervention for painful HR. The presence of TMTJ arthritis was found to be a significant independent risk factor for patients who failed conservative management and needed surgical intervention (p = 0.039). The results of the present study suggest that the presence of TMTJ arthritis has an impact on HR, especially when evaluating the potential failure of conservative management and need for surgical intervention.