First Metatarsophalangeal Joint Space Area Decreases Within 1 Month After Implantation of a Polyvinyl Alcohol Hydrogel Implant: A Retrospective Radiographic Case Series

Shi, Eric; Todd, N. V.; Rush, Shannon M.; Jennings, Meagan M.; Yurgelon, Jesse; Sue, Alan; Bourke, Christopher; Baravarian, Bob; Allen, J.J.; Shofler, David

doi:10.1053/j.jfas.2019.04.007

Cited by 2 publications

(2 citation statements)

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“…They also found a 37.5% revision rate, with all patients having radiographic evidence of joint degeneration. In another retrospective radiographic case series, Shi et al 9 also reported a joint space area decrease within 1 month after polyvinyl alcohol hydrogel surgery. These radiological outcomes were similar to those of our study.…”

Section: Discussionmentioning

confidence: 89%

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Early Failures of Polyvinyl Alcohol Hydrogel Implant for the Treatment of Hallux Rigidus

2020

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Background: The purpose of this study was to evaluate the clinical and radiological outcomes following a polyvinyl alcohol hydrogel implant in the treatment of hallux rigidus. Methods: A retrospective cohort study investigating patients treated with a polyvinyl alcohol hydrogel implant for hallux rigidus was performed. Clinical outcomes were evaluated with the Foot and Ankle Outcomes Score (FAOS) and visual analog scale (VAS) score at the final follow-up. Plain radiographs were assessed postoperatively. Eleven patients (11 feet) with a mean follow-up of 20.9 months (range, 14-27 months) were included. The mean age was 60.3 years. Results: All FAOS subscales showed pre- to postoperative improvements, but there was no statistical significance in all subscales. The mean VAS score showed improvement from 4.1 to 3.0 ( P = .012). On postoperative plain radiographs, implant subsidence was observed 60% (6/10) at 4 weeks after surgery and 90% (9/10) at the final follow-up. Fifty percent (5/10) showed radiologic lucency around the implant. Forty percent (4/10) had erosion of the proximal phalanx of the great toe. Four patients (36%) reported no improvement following surgery at the final follow-up, which were considered as failures. Three patients required additional surgery related to the implants. An additional patient is waiting to revise the implant. Conclusion: Our current cohort study demonstrated a high failure rate with the polyvinyl alcohol hydrogel implant in patients with hallux rigidus. Significant radiologic subsidence with lysis around the implant, erosion of the proximal phalanx countersurface, and implant wear are harbingers for concern in the long term. Level of Evidence: Level IV, case series.

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Section: Discussionmentioning

confidence: 89%

“…Since then, however, there are conflicting reports regarding the success of this implant. 1,4,9 The purpose of the current study was to evaluate the clinical, functional, and radiological outcomes following a polyvinyl alcohol hydrogel implant in the treatment of hallux rigidus in a single-surgeon (J.G.K.) case series.…”

Section: Introductionmentioning

confidence: 99%