Short-Term Functional Outcomes of First Metatarsophalangeal Total Joint Replacement for Hallux Rigidus

Erkoçak, Ömer Faruk; Şenaran, Hakan; Altan, Egemen; Aydın, Bahattin Kerem; Acar, Mehmet Ali

doi:10.1177/1071100713496770

Cited by 34 publications

(12 citation statements)

References 52 publications

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“…Good short-term and long-term functional outcome and high patient satisfaction level were reported with the use of ToeFit-Plus (Plus Orthopedics AG, Switzerland) implants and silicone implant prosthesis[40,41]. Conversely, a loss of ROM and changes in component alignment over time was demonstrated with the use of an anatomically designed 3-component MTP-I prosthesis (Metis, Newdeal SA, Integra Life Science ILS, New Jersey, United States)[38].…”

Section: Arthroplastymentioning

confidence: 99%

Hallux rigidus: How do I approach it?

Lam¹,

Chan²,

Surace³

et al. 2017

WJO

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Hallux rigidus is a degenerative disease of the first metatarsalphalangeal (MTP) joint and affects 2.5% of people over age 50. Dorsal osteophytes and narrowed joint space leads to debilitating pain and limited range of motion. Altered gait mechanics often ensued as 119% of the body force transmit through the 1st MTP joint during gait cycle. Precise etiology remains under debate with trauma being often cited in the literature. Hallux valgus interphalangeus, female gender, inflammatory and metabolic conditions have all been identified as associative factors. Clinical symptoms, physical exam and radiographic evidence are important in assessing and grading the disease. Non-operative managements including nonsteroidal antiinflammatory drugs, intra-articular injections, shoe modification, activity modification and physical therapy, should always be attempted for all hallux rigidus patients. The goal of surgery is to relieve pain, maintain stability of the first MTP joint, and improve function and quality of life. Operative treatments can be divided into joint-sparing vs joint-sacrificing. Cheilectomy and moberg osteotomy are examples of joint-sparing techniques that have demonstrated great success in early stages of hallux rigidus. Arthrodesis is a joint-sacrificing procedure that has been the gold standard for advanced hallux rigidus. Other newer procedures such as implant arthroplasty, interpositional arthroplasty and arthroscopy, have demonstrated promising early patient outcomes. However, future studies are still needed to validate its long-term efficacy and safety. The choice of procedure should be based on the condition of the joint, patient’s goal and expectations, and surgeon’s experience with the technique.

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Section: Arthroplastymentioning

confidence: 99%

Hallux rigidus: How do I approach it?

Lam¹,

Chan²,

Surace³

et al. 2017

WJO

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“…In the present study, the only complication in the arthroplasty group was an infection, which is in agreement with previous reports. 24 The superior clinical results found here possibly reflect the careful patient selection for arthroplasty. It is the opinion of the author that patients selected for arthroplasty should not have a metatarsus primus elevatus, retraction of the achilles-calcaneal-plantar system and any malalignment of the first radius of the foot.…”

Section: Discussionmentioning

confidence: 75%

“…This is in agreement with some of the most recent literature on 1MTP joint replacement. 6,18,19,24 While a few studies have compared the results of 1MTP arthrodesis and arthroplasty, most of them analyze prosthesis from previous generations, which have been associated with poorer results. 12,[24][25][26][27][28] In the present study, however, patients in the arthroplasty group had better clinical and functional results than those submitted to fusion.…”

Section: Discussionmentioning

confidence: 99%

Artrodese versus artroplastia da primeira articulação metatarsofalângica no tratamento do hallux rigidus – Estudo comparativo de pacientes selecionados apropriadamente

et al. 2020

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ResumoObjetivo Historicamente, os resultados da artroplastia da primeira articulação metatarsofalângica (1MTP) eram relativamente ruins; no entanto, melhorias na compreensão da biomecânica normal do pé, nos materiais e no design dos implantes, tornam a artroplastia um tratamento aceitável em pacientes selecionados. O presente estudo pretendeu comparar os resultados clínicos e radiográficos da artrodese com os da artroplastia da 1MTP no tratamento de hallux rigidus e apresentar um racional para seleção de pacientes para artroplastia. Métodos Um total de 36 pacientes (38 pés) com hallux rigidus operados (12 artrodeses e 26 artroplastias) foram prospectivamente incluídos. A dor foi avaliada com recurso à escala visual analógica (VAS) e o resultado funcional usando a escala American Orthopaedic Foot and Ankle Society Hallux Metatarsophalangeal-Interphalangeal (AOFAS-HMI). As complicações e os resultados radiográficos foram também registrados e a taxa de sobrevida calculada para os dois procedimentos. Resultados Todos os pacientes referiram uma melhoria significativa na dor e nos resultados funcionais após a cirurgia. Os pacientes submetidos a artroplastia tiveram melhor resultado funcional na escala AOFAS-HMI (89,7 versus 65.7 pontos; p < 0.001) e melhor alívio da dor (VAS 1,6 versus 3,9 pontos; p ¼ 0,002) quando comparados com os

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“…First MTP joint arthroplasty shows acceptable results in short-term follow-up, 46,47 but an overall unacceptably high revision rate of between 16% and 26%. 48-50 Dawson-Bowling et al even showed a loosening rate of 52% at up to 8 years (Fig.…”

Section: Operative Treatmentmentioning

confidence: 97%

Treatment of hallux valgus deformity

et al. 2016

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Hallux valgus deformity is a very common pathological condition which commonly produces painful disability. It is characterised as a combined deformity with a malpositioning of the first metatarsophalangeal joint caused by a lateral deviation of the great toe and a medial deviation of the first metatarsal bone.Taking the patient’s history and a thorough physical examination are important steps. Anteroposterior and lateral weight-bearing radiographs of the entire foot are crucial for adequate assessment in the treatment of hallux valgus.Non-operative treatment of the hallux valgus cannot correct the deformity. However, insoles and physiotherapy in combination with good footwear can help to control the symptoms.There are many operative techniques for hallux valgus correction. The decision on which surgical technique is used depends on the degree of deformity, the extent of degenerative changes of the first metatarsophalangeal joint and the shape and size of the metatarsal bone and phalangeal deviation. The role of stability of the first tarsometatarsal joint is controversial.Surgical techniques include the modified McBride procedure, distal metatarsal osteotomies, metatarsal shaft osteotomies, the Akin osteotomy, proximal metatarsal osteotomies, the modified Lapidus fusion and the hallux joint fusion. Recently, minimally invasive percutaneous techniques have gained importance and are currently being evaluated more scientifically.Hallux valgus correction is followed by corrective dressings of the great toe post-operatively. Depending on the procedure, partial or full weight-bearing in a post-operative shoe or cast immobilisation is advised. Post-operative radiographs are taken in regular intervals until osseous healing is achieved.Cite this article: Fraissler L, Konrads C, Hoberg M, Rudert M, Walcher M. Treatment of hallux valgus deformity. EFORT Open Rev 2016;1:295-302. DOI: 10.1302/2058-5241.1.000005.

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Short-Term Functional Outcomes of First Metatarsophalangeal Total Joint Replacement for Hallux Rigidus

Abstract: Level IV, retrospective case series.

Cited by 34 publications

References 52 publications

Hallux rigidus: How do I approach it?

Hallux rigidus: How do I approach it?

Artrodese versus artroplastia da primeira articulação metatarsofalângica no tratamento do hallux rigidus – Estudo comparativo de pacientes selecionados apropriadamente

Treatment of hallux valgus deformity

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