scholarly journals The long-term results of resection arthroplasties of the first metatarsophalangeal joint in rheumatoid arthritis

2001 ◽  
Vol 25 (5) ◽  
pp. 312-316 ◽  
Author(s):  
R. Fuhrmann ◽  
J. Anders
Keyword(s):  
Rheumatoid Arthritis ◽  
Metatarsophalangeal Joint ◽  
Long Term Results ◽  
First Metatarsophalangeal Joint

Flexible hinge toe implant arthroplasty for rheumatoid arthritis of the first metatarsophalangeal joint: long-term results

2001 ◽  
Vol 6 (2) ◽  
pp. 141-147 ◽  
Author(s):  
Tadamasa Hanyu ◽  
Hideshi Yamazaki ◽  
Hajime Ishikawa ◽  
Katsumitsu Arai ◽  
Chikako T. Tohyama ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Metatarsophalangeal Joint ◽  
Long Term Results ◽  
First Metatarsophalangeal Joint ◽  
Flexible Hinge

scholarly journals Long-term Results of Hemiarthroplasty for Osteoarthritis of the First Metatarsophalangeal Joint

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0001
Author(s):  
Stefan Beekhuizen ◽  
Ron Onstenk
Keyword(s):  
Patient Satisfaction ◽  
Scale Score ◽  
Operative Treatment ◽  
Primary Outcome ◽  
Metatarsophalangeal Joint ◽  
Long Term Results ◽  
First Metatarsophalangeal Joint ◽  
Satisfaction Rates

Category: Big toe, MTP-1 joint osteoarthritis Introduction/Purpose: Osteoarthritis of the first metatarsophalangeal joint is the second most common disorder affecting the hallux. If non-operative treatment is not efficacious, operative treatment should be considered. Arthrodesis is considered standard care for grade III and IV osteoarthritis of the first metatarsophalangeal joint. If preservation of joint mobility is preferred, implant arthroplasty could be considered. Total arthroplasty is less recommendable because of high failure rates. However, recent studies showed similar short term results after arthrodesis and hemi joint replacement with greater satisfaction rates, as well as low postoperative pain, after hemiarthroplasty. In our study we mainly focussed on long-term subjective results like patient satisfaction as well as patient recommendation for the performed procedure including our primary outcome; the postoperative AOFAS HMI score. Methods: We therefore evaluated primary arthrodesis and hemiarthroplasty as treatment for arthritis of the first metatarsophalangeal joint. All 102 patients operated between January 2005 and December 2011 were asked to participate in our study, sixty-seven patients responded and were included. Forty-seven arthrodesis were performed in 40 patients using different fixation techniques and thirty-one hemiarthroplasties were performed in 27 patients using the BiopPro® First MPJ implant. Both procedures performed for stage 3 or 4 osteoarthritis and patients had been followed for at least five years, the American Orthopaedic Foot and Ankle Society Hallux Metatarsophalangeal Interphalangeal (AOFAS-HMI) scale score was measured as primary outcome. Secondary outcomes addressed satisfaction rates, recommendation of the performed procedure, number of unplanned surgical repeat procedures, return to daily activities (work as well as sports), and influence of smoking and diabetes mellitus on postoperative results. Finally, financial costs for both procedures were calculated. Results: The 47 primary arthrodeses and 31 hemiarthroplasties performed between January 2005 and December 2011 were evaluated. After a mean follow-up of 8.3 years (range 5-11.8) the mean AOFAS-HMI scale score after arthrodesis and after hemiarthroplasty were 72.8±14.5 and 89.7±6.6 respectively (p =.001). Patients were significantly more pleased after hemiarthroplasty (p<.001) and this procedure was better recommended (p<.001). The number of unplanned repeat surgical procedures did not differ between the two groups. No differences were found in postoperative work resumption, but patients returned to sports significantly sooner after hemiarthroplasty (p=.002). No association was found between smoking and the total AOFAS-HMI score. Overall costs, the sum of procedure costs as wel as additional costs, were quite similar for both procedures. Conclusion: Higher postoperative AOFAS HMI scores after a long-term follow-up (mean 8.3 years, range 5-11.8 years) were found after hemiarthroplasty compared to arthrodesis of the MTP-1 joint. Also greater patient satisfaction and better recommendation is seen after hemiarthroplasty. However return to work showed no differences, a significantly faster return to sports was seen after hemiarthoplasty. Based on these long-term results we could recommend hemiarthroplasty in future patient with osteoarthritis of the MTP-1 joint, with modest preference for the younger, more active patients.

Cone Arthrodesis of the First Metatarsophalangeal Joint

Foot & Ankle ◽  
1984 ◽  
Vol 4 (5) ◽  
pp. 244-248 ◽  
Author(s):  
J. E. Johansson ◽  
T. W. Barrington
Keyword(s):  
Average Length ◽  
Metatarsophalangeal Joint ◽  
Valgus Deformity ◽  
Hallux Rigidus ◽  
Long Term Results ◽  
First Metatarsophalangeal Joint ◽  
Hallux Valgus Deformity ◽  
Metatarsophalangeal Joints

The reliability and effectiveness of the treatment of hallux rigidus and sympomatic arthritis of the first metatarsophalangeal joint by the technique of cone arthrodesis are discussed. The authors reviewed the long-term results of cone arthrodesis in 51 patients with 60 operated feet. The average age was 55 years (range, 28 to 75 years) and the average length of follow-up was 39 months (range, 1 to 12 years). On questioning the patients regarding function, cosmesis, and pain, 41 of 51 patients were happy, eight of 51 patients were satisfied, and two of 51 were unhappy with their feet. No patient complained of persistent or recurrent hallux valgus deformity. Radiologically and clinically 58 of 60 first metatarsophalangeal joints were solidly fused. Two patients had a fibrous ankylosis which was functional and painless. Function with respect to gait and ability to walk on tiptoe and run was normal in all patients. In summary, the authors feel that this procedure is a reliable, effective treatment of painful arthritis of this joint.

Charcot Arthropathy of the First Metatarsophalangeal Joint

2012 ◽  
Vol 102 (2) ◽  
pp. 161-164 ◽  
Author(s):  
Markus Wünschel ◽  
Nikolaus Wülker ◽  
Marco Gesicki
Keyword(s):  
Peripheral Neuropathy ◽  
Pain Perception ◽  
Preoperative Evaluation ◽  
Proximal Phalanx ◽  
Metatarsophalangeal Joint ◽  
Long Term Results ◽  
Charcot Arthropathy ◽  
First Metatarsophalangeal Joint ◽  
Shortening Osteotomy

Charcot arthropathy is an acute or subacute, often indolent, non-infectious or tumorous osteoarticular destruction of weightbearing skeletal structures in patients with reduced pain perception due to peripheral neuropathy. The authors present a rare case of progressive Charcot arthropathy of the first metatarsophalangeal joint with accompanying ulcer and foot deformity due to peripheral neuropathy. An arthrodesis of the first metatarsophalangeal joint with resection of the hypertrophic bone and osteophytes using a locking plate was performed. Also a condylectomy of the base of the proximal phalanx digitus II and III as well as a shortening osteotomy of the third metatarsal were conducted. The ulcer was debrided and primarily closed by suture. Mobilization was performed without weightbearing in a postoperative shoe for 6 weeks, the ulcer was completely healed and the arthrodesis had fused. Owing to the complexity of Charcot arthropathy careful preoperative evaluation, timing and dimension of surgery as well as treatment of associated comorbidities and sufficient postoperative care is important to reduce the complication rate and improve long-term results. (J Am Podiatr Med Assoc 102(2): 161–164, 2012)

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