Radiographic and clinical outcomes following modified L-reverse joint-preserving osteotomy for grade II hallux rigidus: A minimum 5-year follow-up.

PURPOSE: To evaluate radiographic and clinical outcomes following joint-preserving surgery using a modified L-reverse osteotomy for grade II hallux rigidus, with a minimum 5-year follow-up. METHODS: A retrospective review of a prospectively collected cohort treated between 2015 and 2017 was performed. Radiographic assessment included first metatarsal length, declination angle, elevation distance and first metatarsophalangeal joint space width. Clinical outcomes were assessed using the Manchester-Oxford Foot Questionnaire (MOxFQ). RESULTS: Fifty-one patients were included. At 3 months, first metatarsal length decreased by 5.9 mm, declination angle increased by 3.3º, and elevation distance decreased by 2.4 mm (all p < 0.001). These changes remained stable at final follow-up. Median MOxFQ score improved from 42.4 to 16.9 (p < 0.001). Three patients required revision surgery. CONCLUSION: Joint-preserving surgery using a modified L-reverse osteotomy provided radiographic correction and clinical improvement. Maintenance of postoperative decompression and alignment correction may contribute to outcomes in moderate hallux rigidus. LEVEL OF EVIDENCE: III.