Functional Outcome of Arthrodesis of the First Metatarsophalangeal Joint Using Parallel Screw Fixation

Brodsky, James W.; Passmore, Roger N.; Pollo, Fabian E.; Shabat, Shay

doi:10.1177/107110070502600205

Cited by 119 publications

(93 citation statements)

References 25 publications

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“…Most of the patients were able to return to jogging, golf, hiking and tennis. However, most of the patients had shoe-wearing limitation after the procedure [4].…”

Section: Discussionmentioning

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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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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“…Most of the patients were able to return to jogging, golf, hiking and tennis. However, most of the patients had shoe-wearing limitation after the procedure [4].…”

Section: Discussionmentioning

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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“…İleri evre halluks rigidus tedavisinde artrodez sıklıkla tercih edilen bir seçenektir ve başarı oranları %90-%100 arasında değişiklik göstermektedir (11)(12)(13)(14). Coughlin ve Shurnas (5) yaklaşık altı yıl takip ettikleri artrodez hastalarında %94 kaynama oranı ile birlikte iyi ve mükemmel sonuç elde etmişlerdir.…”

Section: Discussionunclassified

“…Brodsky ve ark. artrodez uygulanan 60 ayağı ortalama 44 ay takip etmişler; %100 kaynama oranı ile birlikte hastaların %94'ünün eski yaşam tarzına dönebildiğini bildirmişlerdir (12). Goucher ve Coughlin artrodez uyguladıkları 49 ayağı en az bir yıl takip etmişler ve hem kaynama hem de başarı oranlarını %90'nın üzerinde bildirmişlerdir (15).…”

Section: Discussionunclassified

“…Basarak ameliyat öncesi (A), erken postoperatif (B) ve basarak çekilmiş 39. ay son kontrol grafileri (C). 7. ayda vidası çıkartılmış, son kontrol AOFAS skoru 90 %100 kaynama oranı ve %94 başarılı sonuç bildirmişlerdir (12). Kaynamama oranımız literatür ile karşılaştırıldığında tek kortikal kullanmamıza rağmen kabul edilebilir sınırlardaydı.…”

Section: Discussionunclassified

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İleri Evre Halluks Rigidus Tedavisinde Tek Kortikal Vida ile Primer Artrodez

Yavuz¹,

Gül²,

Özer³

et al. 2014

Haseki

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ÖzetAmaç: Bu çalışmanın amacı halluks rigidus nedeniyle artrodez yapılırken tek kortikal vida kullanılmasının klinik ve radyolojik açıdan yeterliliğini değerlendirmektir.Yöntemler: İleri evre halluks rigidus tanısıyla tek kortikal vida kullanılarak artrodez uygulanan 18 hasta (16 kadın, 2 erkek) geriye dönük olarak değerlendirildi. Hastaların yaş ortalaması 58,1 yıl (dağılım 44-69 yıl) idi. Caughlin ve Shurnas'ın evreleme sistemine göre 5 ayak evre 3 ve 13 ayak evre 4 olarak değerlendirildi. Klinik değerlendirme American Orthopaedic Foot and Ankle Society (AOFAS) metatarsofalangeal-interfalengeal skalası ile yapıldı. Son takip grafileri üzerinden halluks valgus açısı, yere göre birinci parmak dorsifleksiyon açısı ölçüldü. Bulgular: Ortalama izlem süresi 32,4 ay (dağılım 14-69 ay) idi. Bir hastada radyolojik kaynamama mevcuttu. Hastaların preoperatif AOFAS skoru ortalama 56,1 (dağılım 38-72) idi. Hastaların son kontrolünde ortalama AOFAS skoru 81,1 bulundu. AOFAS skoruna göre iki hasta (% 11,1) orta, 11 hasta (% 61,1) iyi, beş hastada (% 27,8) Abs tractAim: The aim of this study was to evaluate the clinical and radiological results in patients with severe hallux rigidus who underwent arthrodesis using single cortical screw. Methods:We retrospectively evaluated 18 patients (16 females, 2 males) who underwent arthrodesis for severe hallux rigidus using single cortical screw. The mean age of the patients was 58.1 (range: 44-69) years. According to the Coughlin and Shurnas classification, 5 feet were rated as stage 3 and 13 feet were stage 4. 3 of the stage 3 patients had cheilectomy previously. The American Orthopaedic Foot and Ankle Society (AOFAS) clinical rating scale for the metatarsophalangeal -interphalangeal joints was used for clinical evaluation. Hallux valgus angles and hallux dorsiflexion angles were measured on X-rays. Results:The mean follow-up period was 32.4 (range: 15-69) months. Radiological signs of non-union was found in one patient. The mean preoperative AOFAS score was 56.1 (range: 38-72). The mean final follow-up AOFAS score was found to be 81.1. Moderate results in 2 patients (11.1%), good results in 11 patients (61.1%) and excellent results in 5 patients (27.8%) were obtained. When the last X-rays were evaluated, 15.1° (7-24) valgus at the metatarsophalangeal joint and 11.9° (8-18) extension (to the floor) at the metatarsophalangeal joint were detected. Late surgical wound healing was observed in one patient. The screws were removed due to irritation in 8 (44%) patients. Conclusion:We assume that in the treatment of severe hallux rigidus, arthrodesis using a single cortical screw may be considered as a favorable surgical technique with its high union rates and increased functional results. (The Me di cal Bul le tin of Ha se ki 2014; 52:158-63)

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“…The percutaneous MTP1 fusion is a simple and quick procedure which can achieve functional results comparable to those obtained with open MTP1 fusion with more than 90% of patients satisfied [Womack [7], Goucher [13], Coughlin [19], Flavin [20], Brodsky [21], Yee [22].…”

Section: Discussionmentioning

confidence: 99%

Percutaneous First Metatarso-Phalangeal Joint Fusion

Bauer

2010

Minimally Invasive Surgery of the Foot and Ankle

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Abstract:The first metatarsophalangeal (MTP1) joint fusion is a very useful procedure in forefoot surgery and is still the gold standard for the treatment of severe and painful hallux rigidus. Normal walking and running are possible after MTP1 fusion, the first ray mobility being essentially in the interphalangeal (IP) joint with a compensatory hypermobility in dorsal flexion. Percutaneous MTP1 fusion is a simple procedure providing comparable results to fusions performed with open techniques. Postoperative cares are simplified with an immediate full weight bearing on rigid flat shoes and quick return to normal walking. Bone preparation is an important step and requires an experience in percutaneous forefoot surgery. Arthrodesis positioning and fixation with this percutaneous procedure are simple with possibility of clinical and radiological control. The indications for percutaneous MTP1 fusion are very large and only severe bone loss or osteoporosis represent the limits for this technique.

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Functional Outcome of Arthrodesis of the First Metatarsophalangeal Joint Using Parallel Screw Fixation

Abstract: Arthrodesis of the first MTP joint is not only a successful surgical technique for relief of pain and correction of deformity but also allows a high level of function in everyday life and in recreational activities.

Cited by 119 publications

References 25 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

İleri Evre Halluks Rigidus Tedavisinde Tek Kortikal Vida ile Primer Artrodez

Percutaneous First Metatarso-Phalangeal Joint Fusion

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