Biomechanical Comparison of Fixation Devices for First Metatarsocuneiform Joint Arthrodesis

Knutsen, Ashleen; Fleming, John F.; Ebramzadeh, Edward; Ho, Nathan C.; Warganich, Tibor; Harris, Thomas J.; Sangiorgio, Sophia N.

doi:10.1177/1938640016679698

Cited by 8 publications

(30 citation statements)

References 20 publications

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“…Biomechanically, the IOFix device was previously found to be superior over the crossed screws or a dorsal locking plate device when each of the three modalities was used as a single form of xation. [11] In vitro the IOFix was shown to sustain higher loads, to be stiffer and to sustain a more narrow inter-fragmentary space. [11] In another biomechanical study [16] the IOFix implant, used as a single modality of xation, was compared to a plantar or medial locking plate that were combined with a crossed screw.…”

Section: Discussionmentioning

confidence: 98%

“…[11] In vitro the IOFix was shown to sustain higher loads, to be stiffer and to sustain a more narrow inter-fragmentary space. [11] In another biomechanical study [16] the IOFix implant, used as a single modality of xation, was compared to a plantar or medial locking plate that were combined with a crossed screw. The IOFix was found to be superior in producing primary inter-fragmentary compression forces but inferior in failure susceptibility when compared to other xation methods in that study.…”

Section: Discussionmentioning

confidence: 98%

“…A few xation devices were described in order to obtain additional stability in the fused joint: a lag screw, a dorsal plate, crossed screws, staples and an intraosseous device. [6] The union rate with various implants was found to be consistently around 91% to 100% [7][8][9][10][11][12][13][14] and the need for reoperation due to a prominent hardware was usually between 0-13% [6][7][8][9][10][11][12][13][14] (with the exception of 78% in one study [15]). These reports imply a relative success in obtaining union, but in some cases, as in a single screw implant or a dorsal plate, the secondary procedure rates seem to be too high.…”

Section: Level Of Evidence: 4 Backgroundmentioning

confidence: 99%

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Does the IOFix implant Improve Union Rates?

Segal

Ohana

Nyska

et al. 2020

Preprint

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BACKGROUND First metatarso-phalangeal joint fusion is the current gold standard for severe hallux rigidus. Data regarding the union rate and the re-operation rate when IOFix (an Intra-osseous fixation device, Extremity medical, New Jersey, USA) is used for hallux rigidus fusion is limited but promising. The aim of this study was to review our outcomes with the IOFix implant. METHODS We have conducted a retrospective chart review, following the approval of the hospital IRB committee. Exclusion criteria included bilateral operations on the same patient, multiple surgeries, charcot foot or other structural foot abnormalities (except hallux valgus), rheumatoid arthritis and a recent foot trauma. We collected demographic data, physical examination documentation, functional score evaluations (AOFAS), and Plain radiographic studies. RESULTS Thirty patients were included in the study. The mean age was 60.36±9.12 (range 36 to 77) years, 18 (60%) female patients and 12 (40%) male. Fourteen (53.33%) were left side pathologies. The average follow up period was 36.2±12.31 (range 12 to 54) months. Union was obtained in 28 (93.33%) patients, of whom none had requested a hardware removal due to a prominent hardware during a minimum of 2 year follow up period. The mean postoperative AOFAS score was 80.5±10.87 (range 35 to 90). A more stringent inclusion criteria and fusion definitions would have led to an exclusion of two more patients and a dropout of two patients from the “fused” group, which would have led to a fusion rate of 85.71%.CONCLUSIONS This is the largest series of hallux rigidus patients that were operated with an IOFix device. The rates of fusion and hardware removal in MTPJ1 arthrodesis performed with an IOFix implant were found to be similar at most when compared to previously described rates that were obtained with other cheaper and more simple fixation devices.LEVEL OF EVIDENCE: 4

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 98%

Section: Level Of Evidence: 4 Backgroundmentioning

confidence: 99%

See 1 more Smart Citation

Does the IOFix implant Improve Union Rates?

Segal

Ohana

Nyska

et al. 2020

Preprint

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“…Comparisons of different fixation devices for the modified Lapidus procedure were also performed in previous studies [ 12 , 14 – 16 ]. Knutsen and colleagues compared fixations with crossed screws, a dorsal locking plate without a crossed screw, and the IOFix® device with each other [ 14 ]. They found a higher failure load for the IOFix® compared to the crossed screw procedure and the dorsal locking plate fixation.…”

Section: Discussionmentioning

confidence: 99%

“…New developments in hardware design and implant techniques combined with the patients’ expectations for a fast recovery and return to normal life have triggered recent research for the best implant device and surgical procedure. Many research groups have compared various hardware solutions such as crossed screws, dorsal and plantar locking plates, and intramedullary locking devices in cadaver or synthetic bone studies [ 12 , 14 – 16 ]. Nevertheless, the actual literature shows heterogeneous results referring to recent fixation concepts in this field of foot surgery.…”

Section: Introductionmentioning

confidence: 99%

Biomechanics of common fixation devices for first tarsometatarsal joint fusion—a comparative study with synthetic bones

et al. 2018

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BackgroundHallux valgus disease is a common deformity of the forefoot. There are currently more than 100 surgical approaches for operative treatment. Because hypermobility of the first tarsometatarsal joint is considered to be causal for hallux valgus disease, fusion of the tarsometatarsal joint is an upcoming surgical procedure. Despite the development of new and increasingly stable fixation devices like different locking plates, malunion rates have been reported in 5 to 15% of cases.MethodsBiomechanical comparison of three commonly used fixation devices (a dorsal locking plate, a plantar locking plate, and an intramedullary fixation device) was performed by weight-bearing simulation tests on synthetic bones. Initial compression force and stiffness during simulation of postoperative weight-bearing were analysed.ResultsFixation of the first tarsometatarsal joint with the plantar plate combination demonstrated a higher stiffness compared to fixation with the intramedullary implant or the medial locking plate. The intramedullary device provided the highest initial compression force. Failure was detected in the following ranking: (1) the angle-stable intramedullary fixation device, (2) the medial located plate, and (3) the plantar locking plate.ConclusionThe intramedullary device demonstrated the highest initial compression force of the three tested implants. The plantar locking plate showed the best overall stability during weight-bearing simulation. Further clinical research is necessary to analyse if the intramedullary fixation device needs a longer period of non-weight-bearing to reach a better non-union rate compared to the plantar locking plate.

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