Midterm clinical results of osteochondral autograft transplantation for advanced stage Freiberg disease

Miyamoto, Wataru; Takao, Masato; Sato, Miki; Kawano, Hirotaka

doi:10.1007/s00264-015-3005-2

Cited by 18 publications

(13 citation statements)

References 23 publications

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“…Another surgical option is osteochondral transplantation, and although good results have been reported, especially in athletes, donor site morbidity is known to be a complication. 9,14,24 One of the main disadvantages in retrospective studies is the loss of data. However, we have only 3 missing patients at the final follow-up.…”

Section: Discussionmentioning

confidence: 99%

“…At the early stages of the disease, activity modification, orthoses, and the use of a metatarsal bar can be used as conservative treatment options. 13,24,28,32 Several surgical techniques have been described, such as joint debridement, resection arthroplasty, metatarsal osteotomy, osteochondral transplantation, and interpositional arthroplasty *. However, no consensus has yet been reached as to which of these provides more successful results.…”

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confidence: 99%

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Interpositional Arthroplasty With Extensor Digitorum Brevis Tendon in Freiberg Disease

et al. 2020

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Background: No consensus has been reached in the treatment of Frieberg disease. Our aim was to evaluate medium- to long-term results of patients with advanced Freiberg disease managed with extensor digitorum brevis tendon interpositional arthroplasty. Methods: There were 24 patients (19 females, 5 males) managed with interpositional arthroplasty for advanced Freiberg disease between 2003 and 2015. The mean follow-up was 133.8 (range, 60-198) months. According to Smillie classification, there were 4 grade 3, 13 grade 4, and 7 grade 5 patients. Patients were evaluated preoperatively and at the final follow-up with the American Orthopaedic Foot & Ankle Society (AOFAS) score and metatarsophalangeal joint range of motion and postoperatively with visual analog scale (VAS) and subjective satisfaction evaluation. Joint space was evaluated on x-rays. Results: Mean AOFAS score increased (53.9 to 80.3, P = .001). Eight patients had excellent, 14 had good, and 2 had fair scores. A significant increase was found in dorsiflexion (38.1° [24°-52°] vs 55.3° [34°-65°]; P = .001) and plantarflexion (19.0° [10°-28°] vs 28.6° [19°-39°]; P = .001). Narrowing of the joint space was not seen in any patient, but expansion was determined in all patients (0.39 [0.35-0.47] vs 0.44 [0.41-0.47] cm; P = .002). Of the patients, 9 were very satisfied, 12 were satisfied, 2 were moderately satisfied, and 1 was dissatisfied. The mean postoperative VAS pain score was 1.7 ± 0.9 (0-4). Conclusion: After a minimum 5-year follow-up, most patients with Freiberg disease managed with interpositional arthroplasty using the extensor digitorum brevis tendon had excellent to good functional results with a widening of the joint space. Level of Evidence: Level IV, retrospective case series.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Interpositional Arthroplasty With Extensor Digitorum Brevis Tendon in Freiberg Disease

et al. 2020

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“…However, generally speaking, joint-preserving procedures have been shown to produce superior outcomes to joint-destructive procedures, and the latter should be reserved for Smillie disease stages 4 and 5 [13, 15]. Following promising demonstration of the technique in recent case series, osteochondral autograft transplantation may also develop a role in the operative management of Freiberg’s disease [16, 17].…”

Section: Discussionmentioning

confidence: 99%

Freiberg’s Disease of Bilateral and Adjacent Metatarsals

Donaldson

Harb

Hussain

et al. 2020

Case Rep Orthop Res

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Freiberg's disease is a rare condition characterized by avascular necrosis of the lesser metatarsal heads. The incidence is highest in females, and the disease is usually unilateral, affecting just a single metatarsal. In this report, we describe the first male case of Freiberg's disease involving the second and third metatarsals in both feet, with the aim of highlighting the condition as a potential cause of such forefoot pain. One year of follow-up is provided.

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“…10,13 Recently published case reports presented patients surgically treated with OAT for Freiberg disease reporting favorable results with a small number of cases. 5,20,21,24 In addition, a recent comparative study between OAT and DCWMO also described favorable outcomes of OAT for Friberg disease. 11 Previous studies on OAT for Freiberg disease focused on adolescents (<20 years), although symptoms can develop at any age, with osteochondrosis as a sequela of prior collapse of the metatarsal head.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Osteochondral Autologous Transplantation and Dorsiflexion Closing Wedge Metatarsal Osteotomy for Late-Stage Freiberg Disease in Adults

Kim

Park

et al. 2020

Foot Ankle Int.

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Background: This study aimed to compare the clinical results between osteochondral autologous transplantation (OAT) and dorsiflexion closing wedge metatarsal osteotomy (DCWMO) in symptomatic adult patients with late-stage Freiberg disease. Methods: Between 2012 and 2017, patients with late-stage Freiberg disease surgically treated with OAT (12 patients) or DCWMO (15 patients) were retrospectively identified. The American Orthopaedic Foot & Ankle Society–lesser metatarsophalangeal-interphalangeal (AOFAS-LMI) score, visual analog scale score for subjective pain, and range of motion (ROM) were determined preoperatively and at final follow-up. Postoperative complications were also recorded. Results: The AOFAS-LMI score at final follow-up was significantly greater in the OAT group than in the DCWMO group (95.7 vs 87.9, P < .001), whereas plantarflexion at final follow-up was significantly lower in the DCWMO group than in the OAT group (30.0 vs 24.0 degrees, P = .037). The DCWMO group reported more postoperative complications including postoperative joint stiffness, deformity, and pain recurrence. In the OAT group, one patient complained of mild knee pain. Conclusion: OAT seemed a better procedure for late-stage Freiberg disease compared with DCWMO in adult patients in terms of postoperative functional score and ROM, with lower complication rates. Level of Evidence: Level III, retrospective comparative study.

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Midterm clinical results of osteochondral autograft transplantation for advanced stage Freiberg disease

Abstract: OAT may be effective for advanced stage Freiberg disease. Further studies are necessary before this technique can become the standard operative treatment.

Cited by 18 publications

References 23 publications

Interpositional Arthroplasty With Extensor Digitorum Brevis Tendon in Freiberg Disease

Interpositional Arthroplasty With Extensor Digitorum Brevis Tendon in Freiberg Disease

Freiberg’s Disease of Bilateral and Adjacent Metatarsals

Comparison of Osteochondral Autologous Transplantation and Dorsiflexion Closing Wedge Metatarsal Osteotomy for Late-Stage Freiberg Disease in Adults

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