Intramedullary and Intra-Osseous Arthrodesis of the Hallux Metatarsophalangeal Joint

Drampalos, Efstathios; Vun, Shen Hwa; Fayyaz, Irfan

doi:10.1177/1602400317

Cited by 9 publications

(5 citation statements)

References 19 publications

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“…In this register study on national basis, we found that an arthrodesis of the FMTPJ resulted in improved foot-related pain, function and HrQoL for patients with end-stage HR. This is consistent with earlier research describing fusions as the best treatment for more severe grades of HR [30][31][32] . However, what is usually not described in other studies, and thereby unique in our study, is how the change in PROM score should be interpreted for that specific population.…”

Section: Discussionsupporting

confidence: 92%

Baseline and 1-Year Follow-Up Data of Patients with End-Stage Hallux Rigidus Treated with an Arthrodesis Reported to Swefoot

Cöster,

Osbeck,

Montgomery

et al. 2023

MRAJ

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Background: Hallux rigidus (HR) affects the first metatarsophalangeal joint and is the most common osteoarthritic condition in the foot. The most used surgical treatment for severe cases of HR is an arthrodesis. The aim of this study is to describe patient characteristics, surgical treatment and the patient-reported outcomes for patients treated with arthrodesis for HR using data from Swefoot, the Swedish quality register for foot and ankle surgery. Methods: From Swefoot we extracted data on patients who underwent surgery for HR between January 2014 and December 2019. We included 419 patients with end-stage HR, who had not previously been treated surgically for HR on the same side. The outcome was measured with the Self-reported Foot and Ankle Score (SEFAS) (summary score 0-48) and EuroQol 5 Dimensions (EQ5D) (index 0-1) together with questions regarding appearance, shoe wear and satisfaction. We extracted surgical and patient-reported data preoperatively and 1 year postoperatively. Results: Our patient-population is predominantly female, around 61 years old, and slightly overweight. The arthrodeses are most often fixated with screws and most of the patients are allowed to bear weight immediately after surgery. The mean SEFAS score is 22 preoperatively and 38 postoperatively, the corresponding values for EQ5D index are 0.56 and 0.81 which means that the health-related quality of life (HrQoL) improves significantly after surgery. Conclusion: Patients with severe HR treated with an arthrodesis have reduced pain, improved function and HrQoL according to the patient-reported outcome measures SEFAS and EQ5D. The mean postoperative SEFAS value was close to the mean SEFAS value of the Swedish general population in the same age category. Fixation techniques and postoperative regimen differ among surgeons in the country. This is the first report from Swefoot regarding this patient population.

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Section: Discussionsupporting

confidence: 92%

Baseline and 1-Year Follow-Up Data of Patients with End-Stage Hallux Rigidus Treated with an Arthrodesis Reported to Swefoot

Cöster,

Osbeck,

Montgomery

et al. 2023

MRAJ

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“…In another series, Drampalos et al [ 9 ] from Manchester, United Kingdom, reviewed the results of arthrodesis of the 1 st MTP joint in 23 patients using the IOFIX or HALUX (Extremity Medical, Parsippany NJ, a similar intramedullary device with an anchored post and a lag screw) (Figure 2B ). Patients were followed up for a mean of 19 mo.…”

Section: Resultsmentioning

confidence: 99%

Intraosseous device for arthrodesis in foot and ankle surgery: Review of the literature and biomechanical properties

Benjamin¹,

Ryan²,

Chechelnitskaya³

et al. 2021

WJO

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BACKGROUND Arthrodesis is the surgical fusion of a diseased joint for the purposes of obtaining pain relief and stability. There have been numerous fixation devices described in literature for foot and ankle arthrodesis, each with their own benefits and drawbacks. AIM To review the use of intraosseous devices in foot and ankle surgery. METHODS There were 9 papers included in the review (6 clinical and 3 experimental studies) all evaluating arthrodesis in the foot and ankle using the IOFIX device (Extremity Medical™, Parsippany, NJ, United States). Outcome scores, union rates, as well as complications were analysed. RESULTS IOFIX appears to be safe and effective in achieving arthrodesis of the 1 st metatarsophalangeal, and talonavicular joints with early rehabilitation. In comparison to plate/screw constructs there were fewer soft tissue complications and issues of metalwork prominence. Cadaveric and biomechanical studies on the use of intramedullary fixation for fusion of the tarsometatarsal and ankle joint showed decreased load to failure, cycles to failure and stiffness in comparison to traditional fusion methods using plates and screws, however IOFIX devices produced higher compressive forces at the joint. CONCLUSION We describe the reasons for which this biomechanical behavior of the intraosseous fixation may be favorable, until prospective and comparative studies with larger sample size and longer follow-up confirm the effectiveness and limitations of the method.

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“…Metatarsophalangeal arthrodesis is a treatment that has the ability to correct severe deformities and produces high percentages of good results, besides eliminating any residual pain due to osteoarthritis secondary to deformity, a complication that, as already mentioned, occurs quite often after osteotomies (7)(8)(9)(10)(11)(12)(13) . Hallux valgus represents, in the vast majority of cases, a metatarsophalangeal subluxation with varying degrees of joint incongruity.…”

Section: Introductionmentioning

confidence: 99%

Clinical and radiological outcomes of the first metatarsophalangeal arthrodesis with Kirschner wires for the treatment of severe hallux valgus

Barbosa

Sanhudo

2020

J Foot Ankle

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Objective: To present the clinical and radiographic outcomes of metatarsophalangeal arthrodesis of the hallux with crossed Kirschner wires and cerclage for the treatment of severe hallux valgus. Methods: Twenty-nine feet of 21 consecutive patients who underwent metatarsophalangeal arthrodesis to correct severe hallux valgus between March 2011 and April 2018 were clinically and radiographically evaluated. Results: After an average follow-up period of 42 months, 17 feet (58.6%) generated a response of total satisfaction with the procedure and 12 (41.4%) a response of satisfied with reservations; none of the patients were dissatisfied. Pain assessed using the visual analog scale improved from a mean of 8 before the procedure to 1.2 at follow-up. The American Orthopaedic Foot and Ankle Society score improved from a mean of 26.5 points before the procedure to 78 points at follow-up. The hallux valgus angle improved from a mean of 38.5° in the preoperative period to 13.1° at follow-up, i.e., an improvement of 25.4°. The intermetatarsal angle improved from a mean of 18.8° in the preoperative period to 15° at follow-up. Consolidation of arthrodesis occurred in all cases, but reintervention was required to remove the hardware in 17 operated feet (58.6%). Conclusion: Metatarsophalangeal arthrodesis with crossed Kirschner wires and cerclage for the treatment of severe hallux valgus produced high rates of satisfaction, with substantial improvement in pain and functional parameters, consolidation in all cases and excellent radiological correction, but had the drawback high rate of reintervention for hardware removal. Level of Evidence IV; Therapeutic Study; Case Series.

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Intramedullary and Intra-Osseous Arthrodesis of the Hallux Metatarsophalangeal Joint

Abstract: The intramedullary and intra-osseous devices for arthrodesis of the hallux MTP joint achieved good outcome in terms of AOFAS score, VAS for pain, HVA, DA, bone union, and patient satisfaction.

Cited by 9 publications

References 19 publications

Baseline and 1-Year Follow-Up Data of Patients with End-Stage Hallux Rigidus Treated with an Arthrodesis Reported to Swefoot

Baseline and 1-Year Follow-Up Data of Patients with End-Stage Hallux Rigidus Treated with an Arthrodesis Reported to Swefoot

Intraosseous device for arthrodesis in foot and ankle surgery: Review of the literature and biomechanical properties

Clinical and radiological outcomes of the first metatarsophalangeal arthrodesis with Kirschner wires for the treatment of severe hallux valgus

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