Preliminary Experience With Polyvinyl Alcohol Hydrogel Implant for Pathology of the Second Metatarsal Head

Glazebrook, Mark; Morash, Joel; Alhadhoud, Meshal; Daniels, Timothy R.

doi:10.1177/1071100719866700

Cited by 8 publications

(4 citation statements)

References 19 publications

(23 reference statements)

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“…Demographically, our cohort treated with PVA implant for lesser toe pathologies is consistent with the existing literature with regard to age, sex, and clinical follow-up times. 3,9 Our cohort was 100% female, and 5 of 13 patients presented with Freiberg’s disease, which is consistent with the current literature suggesting the prevalence of Freiberg’s disease predominantly in females. 4,5…”

Section: Discussionsupporting

confidence: 91%

“…6 Previous study has also shown that 80%, 60%, and 50% of second, third, and fourth MT heads, respectively, could accommodate the 8-mm implant. In a recent study by Glazebrook and colleagues, 9 the authors presented a case series of 5 patients who underwent PVA implantation for Freiberg's infraction or arthritis of the second MT head and reported good clinical outcomes and no complications at an average of 25 months of follow-up. The authors utilized the 8-mm implant in all patients.…”

Section: Sizing Of the Implant Remains An Important Considerationmentioning

confidence: 99%

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Outcomes of Polyvinyl Alcohol Hydrogel Implant of the Lesser Metatarsals

et al. 2020

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Background: Lesser toe metatarsophalangeal (MTP) joint pathology presents a challenge for surgical treatment. At our institution, arthroplasty using a polyvinyl alcohol (PVA) hydrogel implant has been utilized in the second and third MTP joints for advanced arthritis, failed management of Freiberg’s infraction, and osteochondral defects. We present a case series describing the clinical outcomes of 13 patients following PVA implantation of the second or third MTP. Methods: We retrospectively identified 13 patients (14 joints) who underwent PVA hydrogel implantation of the second ( n = 12) or third ( n = 2) metatarsal between 2017 and 2019. The average age was 49 (range, 20-67) years, with 100% females. Patient-Reported Outcomes Measurement Information System (PROMIS) scores were collected preoperatively and at an average of 21.1 (range, 8.3-29.2) months postoperatively. Clinical outcomes were also evaluated. The average time to clinical follow-up was 24.7 (range, 7-35.8) months. Results: On average, patients demonstrated pre- to postoperative improvement in all PROMIS domains, with significant improvements in Pain Intensity ( P = .01) and Pain Interference ( P = .01). Five postoperative complications were observed: 1 case of persistent avascular necrosis, 1 revision with implant removal and bone grafting, 1 periprosthetic fracture, and 2 recurrences of pain requiring ultrasound-guided injection. Conclusion: This study represents the largest case series to date evaluating the use of PVA implant in the surgical correction of lesser toe MTP joint pathology. While the PVA implant presents a viable option in the setting of advanced arthritis, Freiberg’s infraction, and certain osteochondral defects, it is not without complications. The specific indications for use of the PVA implant should be carefully considered. Level of Evidence: Level IV, case series.

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Section: Discussionsupporting

confidence: 91%

Section: Sizing Of the Implant Remains An Important Considerationmentioning

confidence: 99%

Outcomes of Polyvinyl Alcohol Hydrogel Implant of the Lesser Metatarsals

et al. 2020

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“…Prosthesis failure occurred in 1 patient. Glazebrook et al 47 presented their preliminary experience with Cartiva (Carticept Medical, Alpharetta, GA, USA), a polyvinyl alcohol hydrogel implant for pathology of the second metatarsal head. The results demonstrated good outcomes and no complications in 5 patients (mean age, 57 years) at a mean follow-up of 25 months.…”

Section: Implant Arthroplastymentioning

confidence: 99%

Evidence-Based Treatment Algorithm for Freiberg Disease

Yoshimura,

Takao,

Wagner

et al. 2023

CARTILAGE

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Freiberg disease is a type of osteonecrosis of the metatarsal head that predominantly occurs in young females and adolescents, although it may occur at any age. The pathophysiology is multifactorial and may involve trauma, altered foot biomechanics, systemic disorders, and arterial insufficiency. The most typical location is the second metatarsal head, but Freiberg disease may also occur in other lesser toes. Nonoperative treatment is best applied in the early stage of the disease; if this is ineffective, surgical treatment is recommended. Currently available surgical procedures include debridement, osteotomy, osteochondral grafting, microfracture, interposition arthroplasty, implant arthroplasty, and metatarsal shortening arthroplasty. In this article, we propose a treatment algorithm for Freiberg disease based on the current literature and expert opinion.

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“…Glazebrook et al 5 reported on 5 cases of polyvinyl alcohol (PVA) hydrogel synthetic cartilage implant hemiarthroplasty of the second metatarsal head using an 8-mm implant. No complications were found, patients reported little to no pain, and good range of motion was noted at a mean of 25 months of follow-up.…”

Section: Forefootmentioning

confidence: 99%

What’s New in Foot and Ankle Surgery

Halai

Richards

Daniels

2021

Journal of Bone and Joint Surgery

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The purpose of this form is to provide readers of your manuscript with information about your other interests that could influence how they receive and understand your work. The form is designed to be completed electronically and stored electronically. It contains programming that allows appropriate data display. Each author should submit a separate form and is responsible for the accuracy and completeness of the submitted information. The form is in six parts. Identifying information. The work under consideration for publication.This section asks for information about the work that you have submitted for publication. The time frame for this reporting is that of the work itself, from the initial conception and planning to the present. The requested information is about resources that you received, either directly or indirectly (via your institution), to enable you to complete the work. Checking "No" means that you did the work without receiving any financial support from any third party --that is, the work was supported by funds from the same institution that pays your salary and that institution did not receive third-party funds with which to pay you. If you or your institution received funds from a third party to support the work, such as a government granting agency, charitable foundation or commercial sponsor, check "Yes". Relevant financial activities outside the submitted work.This section asks about your financial relationships with entities in the bio-medical arena that could be perceived to influence, or that give the appearance of potentially influencing, what you wrote in the submitted work. You should disclose interactions with ANY entity that could be considered broadly relevant to the work. For example, if your article is about testing an epidermal growth factor receptor (EGFR) antagonist in lung cancer, you should report all associations with entities pursuing diagnostic or therapeutic strategies in cancer in general, not just in the area of EGFR or lung cancer.

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Preliminary Experience With Polyvinyl Alcohol Hydrogel Implant for Pathology of the Second Metatarsal Head

Cited by 8 publications

References 19 publications

Outcomes of Polyvinyl Alcohol Hydrogel Implant of the Lesser Metatarsals

Outcomes of Polyvinyl Alcohol Hydrogel Implant of the Lesser Metatarsals

Evidence-Based Treatment Algorithm for Freiberg Disease

What’s New in Foot and Ankle Surgery

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