Minimal resection interposition arthroplasty of the first metatarsophalangeal joint |
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| Institution: | 1. Aristotle University of Thessaloniki, 1st Orthopaedic Department, George Papanikolaou Hospital, Thessaloniki, Greece;2. Aristotle University of Thessaloniki, George Papanikolaou Hospital, Thessaloniki, Greece;3. 424 Army General Training Hospital, Thessaloniki, Greece;1. Department of Orthopaedic Surgery, H.-Hartziekenhuis, Mechelsestraat 24, 2500 Lier, Belgium;2. AZ Monica, Florent Pauwelslei 21, 2100 Deurne, Belgium;3. ZNA Middelheim, Lindendreef 1, 2020 Antwerpen, Belgium;4. Department of Orthopaedic Surgery, Ghent University Hospital, De Pintelaan 185, 9000 Gent, Belgium;1. Affiliated Hospital of Guilin Medical College, 541001 Guilin, Guangxi, PR China;2. Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC 27707, United States;3. Duke Fuqua School of Business, Durham, NC 27707, United States;1. Dr George Mukhari Academic Hospital Ga-Rankuwa, and Orthopaedic Department, Sefako Makgatho Health University, Pretoria, South Africa;2. Netcare Linksfield Orthopaedic Sports & Rehabilitation Centre (Clinic), and Orthopaedic Department, University of the Witwatersrand, Johannesburg, South Africa;3. Charlotte Maxeke Academic Hospital, and Orthopaedic Department, University of the Witwatersrand, Johannesburg, South Africa;1. The University Departments of Orthopaedic Surgery, Frederiksberg Hospital and Departments of Radiology Frederiksberg, Copenhagen, Capital Region, Denmark;2. The University Department of Radiology, Bispebjerg Hospital, Copenhagen, Capital Region, Denmark;3. External reseachers;1. Trauma and Orthopaedic Surgeon, Whiston Hospital, Liverpool, England;2. Surgical Trainee, Whiston Hospital, Liverpool, England;5. University of Hamburg, Hamburg, Germany & University of Utah, Salt Lake City, USA;6. University of Ghent, Ghent, Belgium;7. University of Iowa, Iowa City, USA;8. Hospital for Special Surgery, New York, USA;9. Foot and Ankle Surgery Centre, Toulouse, France;10. Hospital Rummelsberg, Schwarzenbruck, Germany;1. Department of Orthopaedics, Trauma and Reconstructive Surgery, University of Hamburg, Martinistrasse 52, 20246 Hamburg, Germany;2. Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA;3. Department of Osteology and Biomechanics, University of Hamburg, Lottestrasse 59, 22529 Hamburg, Germany;4. Department of Orthopaedics, University of Basel, Petersgraben 4, 4031 Basel, Switzerland |
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| Abstract: | BackgroundInterposition arthroplasty of the first metatarsophalangeal (MTP) joint is a viable alternative to fusion in patients with advanced hallux rigidus. The purpose of this study is to evaluate the midterm results of a modification of the technique.MethodsCase series of 18 interposition arthroplasties were performed on 13 female patients with Grade III–IV hallux rigidus. The technique included cheilectomy, bunionectomy when needed, minimal resection of the base of the proximal phalanx and interposition of a fascia lata allograft in the first metatarsophalangeal joint. Mean follow up was nine years (range 75–136 months). Patients were evaluated according to the AOFAS score, the ability to tip toe and their subjective satisfaction.ResultsThere was a significant difference between preoperative (mean 43.2, range 15–83) and postoperative (mean 77.3, range 40–100) AOFAS scores (p < 0.001). The patients were able to tip toe on 12 of the 18 operated feet and 9 of the 13 patients were satisfied from the operation. All dissatisfied patients had a coexistent hallux valgus deformity.ConclusionsThe technique had satisfactory midterm outcomes in older patients with advanced hallux rigidus without hallux valgus. Advantages of the method are the preservation of tip toe function in most patients and a technically easy conversion to fusion when needed. |
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| Keywords: | Hallux rigidus Interposition arthroplasty Hallux disorders Arthritis |
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