Surgical management of osteochondral lesions of the first metatarsal head: A systematic review |
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| Affiliation: | 1. IRCCS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy;2. IRCCS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy;3. Department of Biomedical and Neuromotor Sciences, University of Bologna, 40123 Bologna, Italy;1. Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, NY, USA;2. Jacksonville Orthopaedic Institute, Jacksonville, FL, USA;1. Consultant Orthopaedic Foot ankle Surgeon IOTAM - Trauma and Orthopaedics Department Hospital Universitario Quironsalud Madrid, Spain;2. Faculty Medicine, UEM, Madrid, Spain;1. Department of Orthopedics, The First People’s Hospital of Lianyungang, Lianyungang 222000, Jiangsu Province, China;2. Suzhou Medical College of Soochow University, Suzhou 215000, Jiangsu Province, China;3. Department of Orthopedics, Wuxi 9th People’s Hospital Affiliated to Soochow University, Wuxi 214026, Jiangsu Province, China;1. Department of Orthopedic Surgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea;2. Department of Orthopedic Surgery, SNU Seoul Hospital, 237 Gonghang-daero, Gangseo-gu, Seoul, Republic of Korea;3. Department of Orthopedic Surgery, Duke University Medical Center, PO Box 2950, Durham, NC 27710, USA;4. Department of Orthopedic Surgery, Hallym University College of Medicine Chuncheon Sacred Heart Hospital, Republic of Korea;5. Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea;6. Department of Radiology, Gil Medical Center, Gachon University College of Medicine, 21, Namdong-daero 774 beon-gil, Namdong-gu, Incheon 21565, Republic of Korea |
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| Abstract: | BackgroundTreating osteochondral lesions of the first metatarsal head can help reducing pain and preventing end-stage arthritic cartilage degeneration and hallux rigidus. Several surgical techniques have been described, but no clear indications are reported. This systematic review aims to offer an overview of the current surgical treatments for focal osteochondral lesions of the first metatarsal head.MethodsThe selected articles were examined to extract data about population, surgical technique, and clinical outcomes.ResultsEleven articles were included. Mean age at surgery was 38,2 years. Osteochondral autograft was the most used technique. After surgery, an improvement was achieved in AOFAS, VAS, and hallux dorsiflexion but not in plantarflexion.ConclusionThere is limited evidence and knowledge regarding the surgical management of the first metatarsal head osteochondral lesions. Various surgical techniques have been proposed, drawn from other districts. Good clinical results have been reported. Further high-level comparative studies are necessary to design an evidence-based treatment algorithm. |
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| Keywords: | Osteochondral lesions Osteochondritis dissecans First metatarsal head Hallux rigidus Osteochondral autograft |
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