Operative Treatment for Osteoarthritis of the First Metatarsophalangeal Joint: Arthrodesis Versus Hemiarthroplasty

Voskuijl, Timothy; Onstenk, Ron

doi:10.1053/j.jfas.2015.06.019

Cited by 17 publications

(9 citation statements)

References 16 publications

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“…Gheorghiu et al[42] observed a marked decrease in patient satisfaction along with significant decrease in ROM in patients with hemiarthroplasty compared to arthrodesis with a mean follow-up of 3.92 years. On the other hand, Voskuijl and Onstenk[43] found patients with hemiarthroplasty in their study reported greater satisfaction. In addition, symptom intensity and magnitude of disability were found comparable in both hemiarthroplasty and arthrodesis.…”

Section: Arthroplastymentioning

confidence: 85%

Hallux rigidus: How do I approach it?

Lam¹,

Chan²,

Surace³

et al. 2017

WJO

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Hallux rigidus is a degenerative disease of the first metatarsalphalangeal (MTP) joint and affects 2.5% of people over age 50. Dorsal osteophytes and narrowed joint space leads to debilitating pain and limited range of motion. Altered gait mechanics often ensued as 119% of the body force transmit through the 1st MTP joint during gait cycle. Precise etiology remains under debate with trauma being often cited in the literature. Hallux valgus interphalangeus, female gender, inflammatory and metabolic conditions have all been identified as associative factors. Clinical symptoms, physical exam and radiographic evidence are important in assessing and grading the disease. Non-operative managements including nonsteroidal antiinflammatory drugs, intra-articular injections, shoe modification, activity modification and physical therapy, should always be attempted for all hallux rigidus patients. The goal of surgery is to relieve pain, maintain stability of the first MTP joint, and improve function and quality of life. Operative treatments can be divided into joint-sparing vs joint-sacrificing. Cheilectomy and moberg osteotomy are examples of joint-sparing techniques that have demonstrated great success in early stages of hallux rigidus. Arthrodesis is a joint-sacrificing procedure that has been the gold standard for advanced hallux rigidus. Other newer procedures such as implant arthroplasty, interpositional arthroplasty and arthroscopy, have demonstrated promising early patient outcomes. However, future studies are still needed to validate its long-term efficacy and safety. The choice of procedure should be based on the condition of the joint, patient’s goal and expectations, and surgeon’s experience with the technique.

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Section: Arthroplastymentioning

confidence: 85%

Hallux rigidus: How do I approach it?

Lam¹,

Chan²,

Surace³

et al. 2017

WJO

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“…The following complications were observed after first MTPJ arthrodesis: nonunion, malposition, pain related to hardware requiring reintervention for removal, discomfort due to loss of mobility, metatarsalgia, and IP joint arthrosis or pain (1)(2)(3)(8)(9)(10)(11)13,(14)(15)(16)(17)(18) . IP joint involvement is one of the most frequent complications, with a prevalence ranging from 30 to 60% (10,13,16,17) .…”

Section: Discussionmentioning

confidence: 99%

“…The literature describes the following treatment options for failed first MTPJ arthrodesis: corrective osteotomies, rescue surgery with MTPJ prosthesis, rescue surgery with resection and interposition of tissues (either local or obtained from distant areas), and IP arthrodesis (1,17,19,20) . Studies that compared long-term results in primary surgery between prosthetic implants and first MTPJ arthrodesis showed controversial results, with no study being categorically favorable to arthroplasty (8,21) . Only one study describes an option for the treatment of hallux IP arthritis after first MTPJ arthrodesis consisting of rescue surgery arthroplasty of the MTPJ with arthrodesis resection combined with interposition of soft tissue (semitendinosus tendon) obtained from the ipsilateral knee and IP fusion (17) .…”

Section: Discussionmentioning

confidence: 99%

“…First metatarsophalangeal joint (MTPJ) arthrodesis is a procedure commonly used for the treatment of severe hallux valgus, hallux rigidus, rheumatoid arthritis, hallux varus, and recurrence or failure of previous operations (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13) . Reported complications include nonunion, malposition, consolidation defects, hardware-related pain, dissatisfaction due to loss of joint mobility, difficulty in wearing shoes, and interphalangeal (IP) joint arthrosis (2,3,(8)(9)(10)(11)(13)(14)(15)(16)(17)(18) . The latter is one of the major causes of discomfort after first MTPJ arthrodesis in the long term (16,17) .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Hallux interphalangeal involvement after metatarsophalangeal joint arthrodesis. Treatment and Results

et al. 2020

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Objective: To assess the involvement of the hallux interphalangeal (IP) joint after first metatarsophalangeal joint (MTPJ) arthrodesis and propose a treatment consisting of MTPJ resection arthroplasty associated with phalangeal osteotomy or IP joint arthrodesis. Methods: We retrospectively analyzed 9 patients treated with MTPJ resection arthroplasty associated with phalangeal osteotomy or hallux IP joint arthrodesis from November 2006 to January 2017. Results: The main causes of MTPJ arthrodesis that subsequently evolved to IP involvement were severe hallux valgus and sequelae or complications of previous hallux valgus operations. Additionally, the reasons leading to rescue surgery were pain, deformity, and/or discomfort. Conclusion: This therapeutic modality is able to relieve symptoms by a simple procedure, with acceptable functional and estheticresults. Level of Evidence IV; Therapeutic Studies; Case Series.

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“…Most previous comparative studies of operative treatment for hallux rigidus have small numbers in each treatment arm. 9,10,16,17,19,22 The data from this study are broadly generalizable, as they represent patients enrolled by 49 surgeons from 12 centers across two countries. This study provides the first thorough evidence of the association between patient factors and clinical outcomes following hallux rigidus surgery.…”

Section: Discussionmentioning

confidence: 99%