Interpositional Arthroplasty With Palmaris Longus Tendon Graft for Osteonecrosis of the Second Metatarsal Head: A Case Report

Arthroscopic Interpositional Arthroplasty of the Second Metatarsophalangeal Joint

“…[2][3][4][5][6][7][8][14][15][16][17][18][19][20][21][22][23][24] Excision of the metatarsal head is not recommended because of the risk of shortening of the toe, a break in the alignment of the metatarsal arch and transfer metatarsalgia, instability of the MTP joint and deformity of the toes, hallux valgus, and gait disturbance. 22,25 Joint replacement arthroplasty has been used in the advanced stages of the disease.…”

“…17 In patients with high levels of physical activity, such as active adolescents, silicone or hemiarthroplasty implants can result in several problems, including inappropriate fit, poor material strength, implant loosening, local bony resorption, a lack of toe purchase, infection, hardware irritation, and transfer metatarsalgia. 23 Nowadays, the use of a silicone implant is not recommended for the management of second MTP degenerative disease in active adults. 22,23 Furthermore, the evidence in published studies is insufficient to support the use of metallic or ceramic materials.…”

“…23 Nowadays, the use of a silicone implant is not recommended for the management of second MTP degenerative disease in active adults. 22,23 Furthermore, the evidence in published studies is insufficient to support the use of metallic or ceramic materials. 22,23 A number of authors have reported information on the success of dorsal wedge osteotomies.…”

“…22,23 Furthermore, the evidence in published studies is insufficient to support the use of metallic or ceramic materials. 22,23 A number of authors have reported information on the success of dorsal wedge osteotomies. However, there are no long-term results to identify transfer metatarsalgia.…”

“…22 Moreover, excessive dissection and/or poor fixation technique can cause major problems such as infection, soft-tissue irritation, malunion, nonunion, aseptic necrosis, and metacarpal shortening. 22,23 El-Tayeby 26 reported an interpositional arthroplasty for Freiberg disease. The tendon of the extensor digitorum longus is used for surfacing and as a spacer.…”