First Metatarsophalangeal Joint Osteoarthritis A Clinical Review

McSweeney, Simon Christopher

doi:10.4172/2165-7025.1000293

Cited by 6 publications

(6 citation statements)

References 31 publications

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“…8 The first metatarsophalangeal (great toe) joint (1st MTP jt) is a condyloid synovial juncture. 9 The metatarso-sesamoid complex consists of the head of the first metatarsal, the base of the proximal phalanx, six muscles, eight ligaments and two sesamoid bones. The base of the proximal phalanx is concave and has a large base to receive its muscular and ligamentous attachments.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of platelet rich plasma (PRP) as a pain management method in Bunion Hallux Valgus; A Case Series

2022

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Chronic foot pain resulting from bunion hallux valgus deformity is a common complaint in family medicine, sport medicine and orthopedics practices especially in females. It is a deformity in metatarsophalangeal joint of big toe because of laxity of joint capsule and ligaments resulting in failure of stabilization of the affected joint. High heels, tight and narrow tiptoe box pointed shoes are potential apparent causes of this pathology. Initial treatment remains conservative with large toe box shoes, pain control medicines and surgery as a last choice. When indicated, surgical treatment is controversial because of the greater than 100 described surgical procedures and a historically high prevalence of recurrence. Platelet rich plasma (PRP) is an autologous treatment and pain management method came out in last twenty years, now it is so popular in orthopaedic, rheumatology and sport medicine practices because of it’s effectiveness and cheapness and safety. The authors reported and managed chronic pain by PRP local injections for four cases complaining from long standing bunion hallux valgus deformity and pain.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of platelet rich plasma (PRP) as a pain management method in Bunion Hallux Valgus; A Case Series

2022

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“…Консервативное лечение ОА ПФС1 является сложной проблемой, требующей доказательного и структурированного подхода с применением патогенетически обоснованных методик. Стоит отметить отсутствие в отечественной и зарубежной литературе достаточного количества высококачественных научно обоснованных работ, посвященных данной проблеме, что может быть связано с различиями в методологии оценки и классификации выраженности ДД изменений в ПФС1, отсутствием стандартного протокола применяемых методик восстановительного лечения и недостатком информации относительно частоты и длительности проводимых мероприятий [23,27,28,29].…”

Section: Discussionunclassified

Complex approach to the conservative treatment of hallux rigidus

Ilchenko¹,

Ilyin

Карданов³

et al. 2021

Naučno-praktičeskaâ revmatologiâ

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Introduction. Hallux rigidus (HR) is a common source of forefoot pain, which leads to progressive loss of range of motion in the first metatarsophalangeal (MTP1) joint and pathologically affects biomechanics of the whole lower limb. HR is characterized by degeneration of the articular surfaces of MTP1 joint with the formation of bone growths, cysts and erosions, osteochondral defects and loose bodies. The frequency of occurrence of HR is 1 in 40 adults older than 50 years, and this localization of osteoarthritis is the most common among all joints of the foot. The aim of this article is to improve the results of conservative treatment of HR through the use of physical rehabilitation methods, such as manual therapy, therapeutic exercises and foot orthotics.Materials and methods. This study included retrospective cases of 24 patients (28 feet), who underwent a single course of conservative treatment of HR at the European Clinic for Sports Traumatology and Orthopedics (ECSTO) of the European Medical Center (EMC) since January 2014 to December 2018. The patients’ mean age was 51 years (range, 41 to 69 years). Median time between the beginning of treatment and final examination was 26 months (interquartile range from 17 to 36 months). Patient satisfaction, VAS pain scale, AOFAS and FAAM questionnaires and MTP1 dorsiflexion were evaluated in this study.Results. According to AOFAS scale, we obtained 18% (5/28) of excellent, 78% (22/28) of good, 4% (1/28) of fair and no poor results. Median AOFAS score significantly increased from 58.5 points before treatment to 87.0 points on the final examination (p<0.05). Median FAAM daily activity subscale showed 98% of functional outcome with median subjective score of 95%, median FAAM sports score was 97% and median subjective sports score rate was 90%. Patient’s satisfaction at the final examination was “excellent” in 57% (16/28), “good” in 39% (11/28), “fair” in 4% (1/28) of cases and no poor results were obtained. Median VAS pain scale decreased from 5 points before treatment to 1 point at the final examination (p<0.05). Median angle of the MTP1 dorsiflexion significantly increased from 23° before treatment to 30° on the final examination (p<0.05).Conclusion. Described approach of the conservative treatment of HR is an effective method of treatment of early stages of the disease with high patient satisfaction rate and functional outcome.

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“…The 1 st MTPJ is a condyloid synovial juncture [86]. It differs from the lesser MTP joints by its sesamoid mechanism: a single dominant fibrocartilaginous capsular thickening does not exist at the 1 st MTPJ in contradistinction to the lesser MTPJs [87,88].…”

Section: Structurementioning

confidence: 99%

Hit and miss: The accuracy of intra-articular injections of the first metatarsophalangeal joint

Reilly

2022

J Int Foot Ankle

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Introduction: Therapeutic injections provide a treatment option for patients with joint and periarticular pain, those who are not surgical candidates, whom conservative treatment has failed, or those that are awaiting surgery. Injectable glucocorticoids are one of the most common therapeutic interventions in musculoskeletal healthcare and are widely used in pathologies of the first metatarsophalangeal joint. The aim of this paper is to highlight current concepts around first metatarsophalangeal joint injection injection accuracy. Anatomy: The first metatarsophalangeal joint is a condyloid synovial juncture and consists of the head of the first metatarsal, the base of the proximal phalanx, six muscles, eight ligaments and two sesamoid bones, with associated ligamentous attachments. The joint capsule is shaped like a box. Methods: To achieve the research aim, a scoping review was undertaken with a search strategy that identified evidence via the following sources: Electronic databases, Google scholar, and Reference lists. Results: The search yielded 193 articles, 48 of which appeared of potential relevance. After removing duplicate articles this total was reduced to 37 articles. After scanning the content, 27 were excluded to leave 10 articles. Twenty eight further articles were found through related author research, examination of reference lists and free text searches of Google Scholar. One reference was unobtainable. The final count of papers utilised for review was 37 which produced three themes, one of which was injection accuracy. Injection accuracy: In the long history of injection therapy, infiltrations have often been performed without image guidance, i.e., using palpation guidance, anatomical landmarks and clinical judgement to direct needle entry and advancement. Needle placement may also be confirmed by use of diagnostic imaging. Typical imaging modalities are fluoroscopy or ultrasound, used alone or in combination with contrast media. Discussion: The perceived wisdom is that if an injectate misses its target it is likely to be less effective and lead to false negative reporting of poor treatment outcomes, but the literature is not equivocal. This article discusses the recent literature in the field. Conclusions: The literature suggests that steroid injections are safe and effective for the short-term relief of joint pain. When injecting small synovial joints using palpated-guided methods, clinicians must be alert to the potential for failure of technique from the needle penetrating too far into the articulation and exiting the joint on the contralateral side from the entry point. Use of shorter needles and use of imaging, +/- the use of contrast media, might reduce the number of such failures.

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First Metatarsophalangeal Joint Osteoarthritis A Clinical Review

Cited by 6 publications

References 31 publications

Effectiveness of platelet rich plasma (PRP) as a pain management method in Bunion Hallux Valgus; A Case Series

Effectiveness of platelet rich plasma (PRP) as a pain management method in Bunion Hallux Valgus; A Case Series

Complex approach to the conservative treatment of hallux rigidus

Hit and miss: The accuracy of intra-articular injections of the first metatarsophalangeal joint

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