Endoprothetik bei Hallux rigidus

Kundert, Hans-Peter; Zollinger-Kies, Hans

doi:10.1007/s00132-005-0827-4

Cited by 33 publications

(18 citation statements)

References 36 publications

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“…In literature, the rate of radiolucent lines around the implants after total first MTP joint replacement varies between 3.1% and 33% [9,12,13,24,30,32]. It can be argued that, in our series, a longer follow-up is required in order to fully assess the clinical and radiological outcomes.…”

Section: Discussionmentioning

confidence: 84%

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Recreational sport activity after total replacement of the first metatarsophalangeal joint: a prospective study

Daniilidis

Martinelli

Marinozzi

et al. 2010

International Orthopaedics (SICOT)

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First metatarsophalangeal joint replacement is an alternative surgical procedure to arthrodesis in the treatment of moderate-to-severe hallux rigidus. However, few studies have been published about functional outcome after joint reconstructive procedures for hallux rigidus. The purpose of this study was to assess clinical, radiological and functional outcome, with special regard to recreational and sports activity, after first metatarsophalangeal joint replacement in patients affected by hallux rigidus grade III. Twenty-three patients who had undergone total joint replacement of the first metatarsophalangeal joint were examined preoperatively and three, six, 12 and 18 months postoperatively. All patients (mean age of 57.0±3.7 years) received a non-cemented TOEFIT-PLUS™ implant by one surgeon. Clinical scores (AOFAS score and VAS), radiological examination, patient satisfaction and sport participation were used to evaluate treatment outcome and radiolucent lines. The mean AOFAS score showed a significant improvement from 44.6±7.2 points preoperatively to an average of 82.5±14.4 points at last follow-up (p<0.001). The mean total ROM of the first MTP joint increased from 28.1±4.9 degrees preoperatively to 52.7±15.7 degrees postoperatively (p<0.001). After surgery, 91.3% of the patients were able to resume at least one recreational activity. Total arthroplasty for the treatment of hallux rigidus in an active patient population revealed good clinical and functional results. However, postoperative recreational sport activity showed a decrease in comparison to the pre-arthritic state. Further follow-up is necessary to quantify loosening risk in active patients after total hallux arthroplasty.

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Section: Discussionmentioning

confidence: 84%

“…The clinical outcomes after first MTP arthroplasty are satisfactory, even though controversial results have been reported concerning revision rates of hemi-and total arthroplasty [10,12,13,23,24,27,30,32].…”

Section: Introductionmentioning

confidence: 99%

Recreational sport activity after total replacement of the first metatarsophalangeal joint: a prospective study

Daniilidis

Martinelli

Marinozzi

et al. 2010

International Orthopaedics (SICOT)

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“…ReFlexion(tm) has a 25% rate of radiological phalangeal loosening and 10% metatarsal [12], and the Moje ceramic toe joint is associated with a high revision rate [12].…”

Section: Discussionmentioning

confidence: 99%

“…The design of the TOEFIT-PLUS TM makes it primarily more stable than other implants and the anchorage and osseointegration problems have been better solved [8][9][10][11][12]. A radiograph of an implantation with uneventful follow-up is shown in figure 4.…”

Section: Discussionmentioning

confidence: 99%

Treatment of hallux rigidus with the TOEFIT-PLUS™ joint replacement system

Seeber

Knessl²

2007

Interact Surg

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Background: Hemi-and total-replacement of the first metatarsophalangeal joint (MTP1) remains controversial due to failures observed in earlier decades. The TOEFIT-PLUS TM system was developed in part to address these earlier failures, but published reports investigating its use have been limited.Materials: The TOEFIT-PLUS TM MTP1 joint replacement system is designed with a self-tapping thread on a conical titanium core that provides cement-free, primary stable anchorage and focal pressure reduction in the corticocancellous bone due to an enlarged surface area. The modular design allows surgeons to decide intraoperatively whether to proceed with hemi-or total arthroplasty. Data from 3 studies are presented: 64 patients receiving total prostheses and followed-up annually (Seeber); 12 hemi-prostheses in 10 patients with 5.1 years average follow-up and 6 total prostheses in 5 patients with 1.5 years average follow-up (Knessl); and 54 prostheses (14 hemi-prostheses, 40 total prostheses) in 52 patients followed-up for an average of 3 years (multicenter study).Results: Seeber reported a 42.7-month service life of the prosthesis at the time of follow-up. Five patients (6.8%) were reoperated. Passive hallux motion was 15-18g reater than active motion, and patient satisfaction at follow-up was high. Knessl reported an average range of motion (ROM) in the sagittal plane of 55˚with an average dorsal extension of 25.3˚and plantar flexion of 30˚in patients who received hemi-prostheses. Prosthesis removal was necessary in 3 patients. Prosthesis loosening has not been observed. In patients undergoing total arthroplasty, ROM was recorded at 58˚. A revision operation was necessary in 1 patient. Revision surgery was necessary in 11 patients (21.1%) in the multicenter study. Patient-reported outcomes were favorable.Conclusion: The TOEFIT-PLUS TM joint replacement system offers improved implant stability and is able to handle high biomechanical loads and neutralize shear forces. When compared with other systems, it is associated with reduced osseointegration problems. Intensive postoperative strategies are recommended. Long-term follow-up studies are needed to further investigate the utility of this system.

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“…3) und Wundheilungsstörungen (2,5%). Hinzu kommt eine bereits radiologisch erkennbare Implantatlockerung von 42% nach durchschnittlich 3 Jahren [12,13,16].…”

Section: Introductionunclassified

Hallux rigidus

Fuhrmann¹

2010

Trauma Berufskrankh

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Die operative Behandlung der fortgeschrittenen symptomatischen Arthrose am Großzehengrundgelenk wird seit Jahrzehnten unverändert kontrovers diskutiert. Während die Maßnahmen der konservativen Therapie (Sohlenversteifung, Ballenrolle) international akzeptiert sind, bestehen unverändert Meinungsverschiedenheiten zur Wahl des operativen Verfahrens. Der verständliche Wunsch des Patienten nach Wiederherstellung einer schmerzfreien Funktionalität des Gelenks und die zahlreichen Neuentwicklungen von Endoprothesenmodellen für das Großzehengrundgelenk haben auf Behandlerseite die Bereitschaft zur Implantation einer Großzehengrundgelenkpro-these erhöht.Nachfolgend werden daher die Vorund Nachteile beider Verfahren -konservativ und operativ -dargestellt. Klinische und radiologische Stadieneinteilung des Hallux rigidusDie Arthrose des Großzehengrundge-lenks verläuft in Stadien, die durch typische klinische und röntgenologische Kriterien gekennzeichnet sind. Deshalb ist es sinnvoll, eine Klassifikation zu verwenden, die beide Befundkategorien angemessen abbildet (. Tab. 1). Eine konsequente Einteilung der Erkrankung nach den definierten Stadien ermöglicht einerseits eine Abschätzung der Befundprogredienz und erleichtert andererseits die Entscheidungsfindung hinsichtlich der geeigneten Behandlungsmaßnahme. Behandlungskonzepte Konservative Therapie Endoprothese des GroßzehengrundgelenksDer

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Endoprothetik bei Hallux rigidus

Cited by 33 publications

References 36 publications

Recreational sport activity after total replacement of the first metatarsophalangeal joint: a prospective study

Recreational sport activity after total replacement of the first metatarsophalangeal joint: a prospective study

Treatment of hallux rigidus with the TOEFIT-PLUS™ joint replacement system

Hallux rigidus

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