Total ceramic arthroplasty for painful, destructive disorders of the lesser metatarso-phalangeal joints

Townshend, David; Greiss, M.E.

doi:10.1016/j.foot.2006.09.006

Cited by 20 publications

(16 citation statements)

References 8 publications

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“…This study presents a hemiarthroplasty technique that does not affect the base of the proximal phalanx for treatment of late-stage, joint-destructive conditions of the second MT head using a synthetic cartilage implant and 5 cases with good outcomes and no complications at a mean 25 months of follow-up. Retrospective case studies have described joint replacement arthroplasty for the treatment of Freiberg’s infraction, using silicone, 4,9,13,16 titanium, 17 or ceramic 19 implants. Problems associated with silicone implants include loosening and excessive wear debris, leading to foreign-body reaction.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2019

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Background: There is no consensus regarding which surgical technique is most beneficial for pathology of the second metatarsophalangeal joint. We report the use of polyvinyl alcohol hydrogel synthetic cartilage implant hemiarthroplasty for pathology of the second metatarsal head that has failed nonoperative treatment and present 5 cases with a minimum 15 months of follow-up. Methods: The technique for synthetic cartilage hemiarthroplasty of the second metatarsal head is described. The postoperative protocol included weightbearing as tolerated for 2 weeks and moderate limitations in activities of daily living to respect wound healing, followed by physiotherapy for range of motion exercises. Charts for patients who underwent this procedure between 2015 and 2017 were retrospectively reviewed. Outcome measures collected postoperatively included a pain visual analog scale, Short-Form 36 (SF-36) Physical Component Summary (PCS) and Mental Component Summary (MCS) scores, and Foot and Ankle Ability Measure (FAAM) Sports and Activities of Daily Living (ADL) current level of function percentages. Results: At 15 to 38 months of follow-up, patients reported little to no pain and good range of motion, with no complications. Mean outcome measure scores were 89 for FAAM ADL, 75 for FAAM Sports, 44.4 for SF-36 PCS, and 52.1 for SF-36 MCS. Conclusion: This preliminary study of synthetic cartilage hemiarthroplasty for treatment of joint-destructive conditions of the second metatarsal head demonstrated good outcomes and no complications in 5 cases at a mean 25 months of follow-up. Large prospective cohort studies are needed to prove the efficacy and safety of this new surgical technique for the treatment of pathology of the second metatarsal head. Level of Evidence: Level IV, retrospective case series.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2019

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“…15,22 In joint arthroplasty with silicone or metallic-ceramic implants, complications have been reported such as infection, unsuitable implant, local bone resorption, implant loosening, and inflammation. 3,15,21,28,30,32 Therefore, silicone, ceramic, or metal implant arthroplasty is not currently recommended. 28,32 In 1979, Gauthier and Elbaz 8 first reported the dorsal wedge osteotomy in Freiberg disease and stated that good results were obtained in 52 of 53 patients irrespective of disease grade.…”

Section: Discussionmentioning

confidence: 99%

Interpositional Arthroplasty With Extensor Digitorum Brevis Tendon in Freiberg Disease

et al. 2020

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Background: No consensus has been reached in the treatment of Frieberg disease. Our aim was to evaluate medium- to long-term results of patients with advanced Freiberg disease managed with extensor digitorum brevis tendon interpositional arthroplasty. Methods: There were 24 patients (19 females, 5 males) managed with interpositional arthroplasty for advanced Freiberg disease between 2003 and 2015. The mean follow-up was 133.8 (range, 60-198) months. According to Smillie classification, there were 4 grade 3, 13 grade 4, and 7 grade 5 patients. Patients were evaluated preoperatively and at the final follow-up with the American Orthopaedic Foot & Ankle Society (AOFAS) score and metatarsophalangeal joint range of motion and postoperatively with visual analog scale (VAS) and subjective satisfaction evaluation. Joint space was evaluated on x-rays. Results: Mean AOFAS score increased (53.9 to 80.3, P = .001). Eight patients had excellent, 14 had good, and 2 had fair scores. A significant increase was found in dorsiflexion (38.1° [24°-52°] vs 55.3° [34°-65°]; P = .001) and plantarflexion (19.0° [10°-28°] vs 28.6° [19°-39°]; P = .001). Narrowing of the joint space was not seen in any patient, but expansion was determined in all patients (0.39 [0.35-0.47] vs 0.44 [0.41-0.47] cm; P = .002). Of the patients, 9 were very satisfied, 12 were satisfied, 2 were moderately satisfied, and 1 was dissatisfied. The mean postoperative VAS pain score was 1.7 ± 0.9 (0-4). Conclusion: After a minimum 5-year follow-up, most patients with Freiberg disease managed with interpositional arthroplasty using the extensor digitorum brevis tendon had excellent to good functional results with a widening of the joint space. Level of Evidence: Level IV, retrospective case series.

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“…La prise en charge thérapeutique peut être [1,4,5,10,[12][13][14][15][16][17][18][19][20][21][22] : médicale :…”

Section: Discussionunclassified

“…Il nous semble qu'elle n'agisse pas sur la qualité de l'interligne articulaire, et que l'amélioration de la symptomatologie qu'elle procure est surtout due au transfert de la charge et à la décompression articulaire ;-remplacement prothétique : les séries présentées dans la littérature sont peu représentatives et à faible recul. Il nous semble qu'elle doit être réservée aux échecs du traitement conservateur[19] ; -autoplastie tendineuse d'interposition de KEHR[20] : pour les stades évolués de la maladie, avec une destruction étendue de l'articulation, vu les mauvais résultats enregistrés par la technique de prothèse(17-37 % d'échec), les auteurs préfèrent actuellement l'autoplastie tendineuse qui donne une satisfaction subjective et clinique. Il n'y a pas de nécessité de fixation ou d'implantation d'un matériel étranger ; il y a un raccourcissement minimal du métatarsien et un taux bas de complications (déficit d'extension de l'orteil).…”

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L’ostéotomie de dorsiflexion dans le traitement de la maladie de Freiberg

et al. 2009

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Total ceramic arthroplasty for painful, destructive disorders of the lesser metatarso-phalangeal joints

Cited by 20 publications

References 8 publications

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

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

Interpositional Arthroplasty With Extensor Digitorum Brevis Tendon in Freiberg Disease

L’ostéotomie de dorsiflexion dans le traitement de la maladie de Freiberg

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