Background: Although arthroscopic surgical treatment of the first metatarsophalangeal (MTP) joint involves painful\nsesamoid excision, synovectomy, debridement, and partial cheilectomy, no gold standard treatment technique has\nbeen defined in the literature for hallux rigidus and focal osteochondral lesions. This study aimed to assess the\narthroscopic treatment for early grade focal osteochondral lesions of the first MTP joint and to determine the\nimpact of arthroscopic microhole drill surgery on foot function and activities of daily living in a group of patients\nwho failed conservative treatment.\nMethods: This prospective study included 14 patients with hallux rigidus and focal osteochondral lesions of the\nfirst MTP joint who underwent surgery in 2014 and were followed on a regular basis thereafter.\nResults: The patients had mean preoperative VPS (visual pain score) and AOFAS (American Orthopedic Foot and\nankle Society)-Hallux scores of 8.14 �± 0.86 SD and 48.64 �± 4.27, respectively; the corresponding postoperative values\nof both scores were 1.86 �± 0.66 SD and 87.00 �± 3.70. Both VPS and AOFAS-Hallux scores changed significantly.\nDiscussion: In this prospective study, we explored the impact of arthroscopic microhole drill surgery on foot\nfunction and activities of daily living in patients with focal osteochondral lesions of the first MTP joint. Our results\nshowed significant improvements in VPS and AOFAS scores with this treatment.\nConclusions: An arthroscopic microhole drill technique can be used with impressive functional scores and without\nany complications in patients who failed conservative therapy for hallux rigidus with focal chondral injury.
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