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

Abstract

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.

The long-term outcome of silastic implant arthroplasty of the first metatarsophalangeal joint: a retrospective analysis of one hundred and eight feet

“…This is consistent with the findings of Cracchiolo et al [4] (35 degrees), Pontell and Gudas [17] (49 degrees) and Swanson et al [2] (52 degrees). First, MTPJ arthroplasty offers an alternative to arthrodesis in treatment of hallux rigidus with satisfactory functional outcome [19].…”

A comparison between metatarsal head-resurfacing hemiarthroplasty and total metatarsophalangeal joint arthroplasty as surgical treatments for hallux rigidus: a retrospective study with short- to midterm follow-up

“…Preoperative average VAS pain scores in the cited study also improved, from 7.0 preoperatively to 2.0 at the final follow-up; however, radiolucent lines were noted in 13% of patients 44. Barták et al45 retrospectively studied 28 patients who had undergone either hemiarthroplasty or total joint arthroplasty.…”

“…Daniilidis et al44 reported an increase in the average AOFAS score from 44 preoperatively to 82.5 at 18 months postoperatively. Preoperative average VAS pain scores in the cited study also improved, from 7.0 preoperatively to 2.0 at the final follow-up; however, radiolucent lines were noted in 13% of patients 44.…”

Total Toe Replacement in the United States

“…Many patients had a decrease in sporting activity and had substantial difficulty returning to higher impact activities, such as soccer and running. 30 Further study results may be seen in Table 3. Many of the studies are small series with relatively short follow-up.…”