Valenti resection arthroplasty for hallux rigidus: A systematic review

Abstract

Background: Valente Valenti proposed in 1976 a "V" resection of the first metatarsophalangeal joint (MPT1) on the sagittal plane for advanced stages of hallux limitus/rigidus, preserving length of the first ray, flexor hallux brevis and sesamoid function. The available literature concerning correct indications, management and clinical outcomes of the Valenti procedure (VP) and its modifications in patients affected by hallux limitus/rigidus was systematically analyzed.

Methods: Titles and abstracts of all selected articles were independently screened by two authors to assess their suitability to the research focus.

Results: Selection produced 8 articles as full-text, for a total of 347 patients, with a mean follow-up of 6±7.1 (range 0.2-17.5) years. Most common complication was transient sesamoiditis in 21 (7.4%) patients. No substantial differences in clinical outcomes were found between the original and modified techniques.

Conclusions: VP appears to allow an early recovery with few complications, if compared to fusion, interposition arthroplasties or osteotomies. The wide joint resection does not prevent, if necessary, further procedures such as fusion or implants.

Level of evidence: Level I, systematic review.

Keywords: Arthroplasty; Big toe arthritis; First metatarsophalangeal joint; Hallux limitus; Hallux rigidus; Valenti procedure.