Synthetic Cartilage Implant Hemiarthroplasty for Second MTP Joint Osteoarthrosis

Kilmartin, Tim; Posmyk, Lesley

doi:10.1053/j.jfas.2019.08.035

Cited by 3 publications

(6 citation statements)

References 23 publications

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“…This study found a large cohort of participants to experience persistent neurovascular symptoms, swelling, and stiffness at the final follow-up. Only one study reported these symptoms, finding 43% of patients undergoing SCI to experience stiffness [ 24 ]. In this study, 50% of participants reported a restricted ROM at the final follow-up.…”

Section: Discussionmentioning

confidence: 99%

“…However, Lee et al reported mixed results with 68.8% experiencing better post-operative ROM compared to 24% experiencing a worsening ROM [ 25 ]. The number of patients reporting functional restrictions and limited ROM at final follow-up varied from 9.5% [ 24 ] to 27.3% [ 26 ] with some studies demonstrating no significant improvement in pre- to post-operative ROM [ 27 ] and reported gain only in dorsiflexion with no benefit to plantarflexion [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…Functional assessment varied between studies in their use of different rating scales (Table 4 ). At both short and mid-term follow-ups, there is strong evidence to demonstrate a significant improvement in physical function, abilities in activities of daily living, walking, standing, sports, and social interaction [ 4 , 11 , 13 , 17 , 18 , 20 , 24 , 27 ] with one study presenting 96% of patients reaching normal or nearly normal levels of function at five years follow-up [ 19 ]. Conversely, An et al reported their PROMIS scores at final follow-up to equate to a moderate physical dysfunction [ 15 ] with others demonstrating no significant difference in sporting abilities or PROMIS physical function scores from baseline to final follow-up [ 23 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

“…This study found that 55% of patients were still experiencing pain at the final follow-up. The success of SCI surgery in reducing pain from baseline is well founded with reports of significant improvement in PROMIS pain interference/intensity [ 20 ], VAS [ 11 , 21 , 25 ], and MOXFQ [ 24 ] scores from as early as six weeks post-surgery. However, despite these significant improvements, a plethora of studies still report patients experience persistent pain [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

“…Despite these findings, Shimozono et al found only 36.4% of patients were satisfied [ 26 ] and Casinelli et al found 27% to be unsatisfied [ 14 ]. Reasons commonly reported for dissatisfaction included cosmesis, persistence of symptoms, prolonged footwear restrictions, and later need for revision to arthrodesis [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

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Surgical Outcomes of Synthetic Cartilage Implant Hemiarthroplasty for Metatarsophalangeal Arthropathy

Schapira,

Johnson,

Faroug

2023

Cureus

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Introduction Metatarsophalangeal joint (MTPJ) arthropathy in the great toe causes considerable pain and debilitation, severely impacting quality of life. Traditional management options included conservative measures, steroid injections, and arthrodesis. New options include Cartiva, a synthetic cartilage hemiarthroplasty for the MTPJ. This prosthesis has evidence of improved pain and function without the sacrifice of joint movement seen with arthrodesis. However, the implant itself has mixed reviews. This study aims to identify the pre-, peri, and short-term post-surgical outcomes of Cartiva surgery and review the literature for existing reported outcomes. Methods We retrospectively reviewed a cohort of 22 consecutive Cartiva procedures between 2016 and 2022 in a single UK institution. Hospital records were analyzed for peri-operative complications, implant survival, additional operative interventions, patient-reported outcomes, and functional improvement. Results Twenty-one patients underwent Cartiva for the first MTPJ pathology and one for the third MTPJ pathology. Prior to surgery, 40.9% of patients had undergone alternative therapies, including MTPJ steroid injections (seven patients), cheilectomy (four patients), and bunionectomy (one patient). Total complication rates, inclusive of medical, surgical, and implant complications were 45.5% (10/22). Total reoperation rates were 18.2% (4/22) including two revisions to arthrodesis and two manipulations under anesthesia (MUA) with local anesthetic injection. At the final follow-up, 55% were still experiencing pain, 15% neurovascular symptoms, 10% swelling, and 50% stiffness or reduced range of movement. However, 85% of patients returned to usual activities of daily living within two years. Conclusion Cartiva surgery for metatarsophalangeal arthropathy has demonstrated outcomes of persistent pain, limited range of movement, and restricted function at short-term follow-up. Rates of reoperation and revision to arthrodesis were comparable with similar studies.

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Section: Discussionmentioning

confidence: 99%