Hemiarthroplasty Versus Total Joint Arthroplasty for Hallux Rigidus: A Systematic Review and Meta-analysis

Stibolt, Robert; Patel, Harshadkumar; Lehtonen, Eva; DeBell, Henry; Moon, Andrew S.; Naranje, Sameer; Shah, Ashish

doi:10.1177/1938640018791017

Cited by 16 publications

(3 citation statements)

References 39 publications

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“…The highest level of evidence supporting interposition arthroplasty are 3 retrospective case-control studies. A similar conclusion was published by Stibolt et al, 17 who determined, in a systematic review assessing the outcomes of hemi and total joint arthroplasty for hallux rigidus, that the highest level of evidence supporting arthroplasty is again a retrospective case-control study. The only other level I study available in the literature assessing surgical options for hallux rigidus other than the one identified by the current review 9 was a randomized controlled trial assessing the outcomes of arthrodesis and total replacement arthroplasty by Gibson et al 19 This puts the current evidence available for a PVA implant in perspective, as overall the evidence regarding surgical treatment for hallux rigidus is limited in its quality.…”

Section: Discussionsupporting

confidence: 73%

“…Regarding surgical treatment for hallux rigidus in particular, there are multiple systematic reviews of the literature evaluating different surgical modalities. 3,17,18 In an article reviewing the evidence for interposition arthroplasty, Patel et al 18 identified 15 publications, of which 80% were level IV evidence. The highest level of evidence supporting interposition arthroplasty are 3 retrospective case-control studies.…”

Section: Discussionmentioning

confidence: 99%

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The Use of a Synthetic Cartilage Implant for Hallux Rigidus: A Systematic Review

Smyth

Hannon

Kaplan

et al. 2020

Foot & Ankle Specialist

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Background. Hallux rigidus is a common pathology afflicting the foot, for which various joint salvage techniques have been described with a multitude of different implants. Recently, a synthetic cartilage implant composed of polyvinyl alcohol (PVA) received FDA premarket approval for the treatment of arthritis of the great toe. The purpose of this study was to (1) systematically review the clinical evidence supporting the use of a PVA implant in hallux rigidus and (2) determine the strength of the recommendation that can be made supporting the use of a PVA implant by evaluating the quality of evidence available. Methods. A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Using the terms “cartiva OR polyvinyl alcohol OR synthetic cartilage OR hemiarthroplasty AND hallux rigidus OR great toe arthritis OR first toe arthritis” we searched the PubMed/Medline database. The quality of the included studies was evaluated using the American Academy of Orthopaedic Surgeons Clinical Practice Guideline and Systematic Review Methodology. Results. Seven studies met the inclusion criteria, 6 of these were derived from a single randomized controlled trial. A moderate recommendation can be given for the use of a PVA implant for hallux rigidus based on short-term outcomes. A limited recommendation can be given for the use of a PVA implant for hallux rigidus based on mid-term outcomes. Conclusion. There are limited studies available detailing the outcomes of a PVA implant for hallux rigidus; however, the results that are available demonstrate a high level of evidence. Levels of Evidence: Level I: Systematic review

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Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 99%

The Use of a Synthetic Cartilage Implant for Hallux Rigidus: A Systematic Review

Smyth

Hannon

Kaplan

et al. 2020

Foot & Ankle Specialist

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“…28 Another showed that MTP-1 hemiarthroplasty may improve postoperative pain and function to a greater extent than total hemiarthroplasty. 42 Metatarsal erosion can be taken into discussion in conversion arthrodesis.…”

Section: Discussionmentioning

confidence: 99%

Five-Year Prospective Roentgen Stereophotogrammetric and Clinical Outcomes of the BioPro MTP-1 Hemiarthroplasty

et al. 2021

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Background: Mixed results for functional outcomes and long-term fixation have been reported for first metatarsophalangeal arthroplasty. This prospective study was designed to evaluate the migration of the BioPro metatarsophalangeal-1 (MTP-1) joint hemiprosthesis with Roentgen stereophotogrammetric analysis (RSA). Migration patterns of the prosthesis, prosthesis-induced erosion of the metatarsal bone, and clinical outcomes were evaluated sequentially to 5 years postoperation (PO). Methods: Eleven female patients received the BioPro-1 hemiprosthesis. Prosthesis translation and metatarsal erosion were measured with RSA at immediately PO, 6 weeks, and 3, 6, 12, 36, and 60 months postoperatively. Clinical assessment was done by patient questionnaires. Results: RSA data of 9 patients were available for analysis. Median (range) number of markers used in RSA analysis, condition number, and mean error of markers around the prosthesis were 4 (3-7), 320 (208-862), and 0.13 (0.02-0.28), respectively. Progressive subsidence was seen up to 3 years PO (mean 2.1 mm, SE 0.32). Progressive metatarsal erosion was found from 1 year PO (mean 0.49 mm, SE 0.15). Pain, function, and quality scores improved after surgery and did not deteriorate at later follow-up moments. Conclusion: Model-based RSA of the BioPro-1 prosthesis shows nonstabilizing medial and distal translation and metatarsal erosion. Despite the measured migration and erosion, clinical outcomes improved and remained similar up to 5 years postoperation.

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Osteoarthritis of the 1st Metatarsophalangeal Joint

Ekhtiari

Kishta

2021

Evidence‐Based Orthopedics

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Hemiarthroplasty Versus Total Joint Arthroplasty for Hallux Rigidus: A Systematic Review and Meta-analysis

Abstract: Level IV: Systematic review.

Cited by 16 publications

References 39 publications

The Use of a Synthetic Cartilage Implant for Hallux Rigidus: A Systematic Review

The Use of a Synthetic Cartilage Implant for Hallux Rigidus: A Systematic Review

Five-Year Prospective Roentgen Stereophotogrammetric and Clinical Outcomes of the BioPro MTP-1 Hemiarthroplasty

Osteoarthritis of the 1st Metatarsophalangeal Joint

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