Follow-up results 17 years after resection arthroplasty of the great toe

1998 ◽  
Vol 117 (8) ◽  
pp. 457-460 ◽  
Author(s):  
H. Flamme ◽  
N. Wülker ◽  
K. Kuckerts ◽  
F. Gossé ◽  
C. J. Wirth
Keyword(s):  
Resection Arthroplasty ◽  
Great Toe

scholarly journals The Use of a Synthetic Cartilage Implant for Hallux Rigidus

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0045
Author(s):  
Niall Smyth ◽  
Jonathan Kaplan ◽  
Amiethab Aiyer
Keyword(s):  
Polyvinyl Alcohol ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Hallux Rigidus ◽  
Reference List ◽  
Great Toe ◽  
Level Of Evidence ◽  
High Level ◽  
Ability Measure

Category: Other Introduction/Purpose: Hallux rigidus is one of the most common pathologies afflicting the foot. Various joint salvage techniques have been described with a multitude of different implants. Recently, a synthetic cartilage implant composed of polyvinyl alcohol (PVA) received FDA premarket approval for treatment of arthritis of the great toe and has been used in over 4,000 cases. The purpose of this study was to systematically review the clinical evidence supporting the use of a PVA implant in hallux rigidus. Methods: A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Using the terms “cartiva OR polyvinyl alcohol OR synthetic cartilage OR hemiarthroplasty AND hallux rigidus OR great toe arthritis OR first toe arthritis “ we searched the PubMed/Medline database in December 2017. In addition, the reference list of publications were scanned for further relevant studies. Results: 4 studies met the inclusion criteria, all of which were derived from a single randomized controlled trial. At short-term follow-up (2 years), patients undergoing placement of a PVA implant had significant improvement in Foot and Ankle Ability Measure (FAAM) sports and activity of daily living, as well as VAS pain scores. The outcomes of the surgery were found to be noninferior compared to arthrodesis. At intermediate follow-up (5 years), the improvement in clinical outcomes persisted and implant survivorship was 96%. Conclusion: There are limited studies available detailing the outcomes of a PVA implant for hallux rigidus, however the results that are available demonstrate a high level of evidence. There are no long-term publications assessing the outcomes of a PVA implant for hallux rigidus.

scholarly journals Thumb CMCJ prosthetic total joint replacement: a systematic review

2021 ◽  
Vol 6 (5) ◽  
pp. 316-330
Author(s):  
Thomas J. Holme ◽  
Marta Karbowiak ◽  
Jennifer Clements ◽  
Ritesh Sharma ◽  
Johnathan Craik ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cohort Studies ◽  
Joint Replacement ◽  
Total Joint Replacement ◽  
Resection Arthroplasty ◽  
High Quality ◽  
Painful Condition ◽  
Pain Scores ◽  
Patient Reported

Thumb carpometacarpal joint (CMCJ) arthritis is a common and painful condition. Thumb CMCJ prosthetic replacement aims to restore thumb biomechanics and improve pain and function. Early reviews demonstrated a lack of high-quality studies, but more recently a significant number of higher-quality studies have been published. This review provides a concise and systematic overview of the evidence to date. A systematic review of several databases was conducted according to PRISMA guidelines. Studies evaluating the outcomes of thumb CMCJ prosthetic total joint replacement were included. Data extracted included patient-reported outcome measures (PROMs), pain scores, range of motion, strength, survival rates and complications. A total of 56 studies met all inclusion criteria and were analysed. There was one randomized controlled trial, three prospective comparative cohort studies, five retrospective comparative cohort studies, and 47 descriptive cohort studies. The reported studies included 2731 patients with 3048 thumb total CMCJ prosthetic joint replacements. Follow up ranged from 12 months to 13.1 years. In general, good results were demonstrated, with improvements in PROMs, pain scores and strength. Failure rates ranged from 2.6% to 19.9% depending upon implant studied. Comparative studies demonstrated promising results for replacement when compared to resection arthroplasty, with modest improvements in PROMs but at a cost of increased rates of complications. Studies reporting outcomes in thumb CMCJ prosthetic total joint replacement are increasing in both number and quality. Failure, in terms of loosening and dislocation, remains a concern, although in the medium-term follow up for modern implants this issue appears to be lower when compared to their predecessors. Functional outcomes also look promising compared to resection arthroplasty, but further high-quality studies utilizing a standardized resection arthroplasty technique and modern implants, together with standardized core outcome sets, will be of value. Cite this article: EFORT Open Rev 2021;6:316-330. DOI: 10.1302/2058-5241.6.200152

Minimum 5-Year Outcomes and Return to Sports After Resection Arthroplasty for the Treatment of Sternoclavicular Osteoarthritis

2020 ◽  
Vol 48 (3) ◽  
pp. 715-722 ◽  
Author(s):  
Travis J. Dekker ◽  
Lucca Lacheta ◽  
Brandon T. Goldenberg ◽  
Marilee P. Horan ◽  
Jonas Pogorzelski ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Clinical Outcomes ◽  
Short Form ◽  
Case Series ◽  
Sports Participation ◽  
Resection Arthroplasty ◽  
Physical Component Score ◽  
Return To Sports ◽  
Articular Disk

Background: Osteoarthritis of the sternoclavicular (SC) joint is a rare condition that leads to decreased function and persistent pain, ultimately altering the function of the shoulder and keeping individuals from their desired activities. SC resection in the setting of primary and posttraumatic osteoarthritis is the most common surgical treatment for these patients, but midterm results are lacking. Purpose/Hypothesis: The purpose was to assess the clinical outcomes, pain levels, return to sports rate, and survivorship after open SC joint resection in the setting of painful primary SC joint osteoarthritis. We hypothesized that an SC joint resection of maximum 10 mm would result in a significant improvement in clinical outcomes, decreased pain levels, a high rate of return to sports, and a high survivorship. Study Design: Case series; Level of evidence, 4. Methods: Patients who underwent SC joint resection (maximum 10 mm) by a single surgeon between the years 2006 and 2013 with minimum 5-year follow-up were reviewed. The following clinical outcomes were collected prospectively during this time period: 12-Item Short Form Health Survey Physical Component Score (SF-12 PCS), American Shoulder and Elbow Surgeons (ASES) score, Single Assessment Numerical Evaluation (SANE) score, Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) score, and patient satisfaction. Return to sports and pain were assessed through use of a customized questionnaire. Survivorship of SC joint resection was defined as not requiring further surgery on the affected joint. Results: A total of 21 SC joints were treated with resection of the medial clavicle and intra-articular disk and capsulorrhaphy for SC joint osteoarthritis in 19 patients with a mean age of 39.4 years (range, 12.5-66.7 years). At minimum 5-year follow-up, 19 SC joint resections were assessed in 16 of 19 patients (84%) with a mean follow-up of 6.7 years (range, 5.0-10.4 years). All outcome scores improved significantly from pre- to postoperative assessments: ASES (from 54 to 90.5; P = .003), SANE (from 61.8 to 90.4; P = .004), QuickDASH (from 43.1 to 13.8; P = .004), and SF-12 PCS (from 39.8 to 51.3; P = .004). Median satisfaction with surgical outcomes was 9 (range, 2-10), and pain levels improved from a score of 8 out of 10 to 3 out of 10 (scale of 0 to 10 with 0 being pain free and 10 worst possible pain). Of the 13 patients who answered the optional sports participation question, 13 (100%) patients had participated in sports before their injury. A total of 14 patients answered the question on sports participation after injury, with 12 (86%) indicating successful return to sports. Pain at its worst ( P = .003) and pain with competition ( P = .017) significantly decreased pre- to postoperatively. Resection survivorship at final follow-up was 84.2% at 5 years. We found that 3 patients (15%) had recurrent SC joint pain and were treated with revision surgery. Conclusion: Open SC resection arthroplasty with capsulorrhaphy in the setting of pain for SC osteoarthritis results in significant improvement in clinical outcomes, patient satisfaction, return to sports, and pain reduction at minimum 5-year follow-up.

Microvascular Great Toe Transfer For Congenital Absence Of The Thumb

HAND ◽  
1978 ◽  
Vol os-10 (2) ◽  
pp. 113-124 ◽  
Author(s):  
B. Mcc. O'brien ◽  
M. J. M. Black ◽  
W. A. Morrison ◽  
A. M. Macleod
Keyword(s):  
Congenital Absence ◽  
Great Toe ◽  
Long Term Follow Up ◽  
Toe Transfer

summary Two cases of microvascular great toe transfer for congenital absence of the thumb in children are reported. A rationale and operative details are discussed. A long term follow up is needed, but at this stage the results are most encouraging. There has been no interference with gait.

scholarly journals Therapeutic Management of the Hallux Rigidus

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Anoop Aggarwal ◽  
Suraj Kumar ◽  
Ratnesh Kumar
Keyword(s):  
Manual Therapy ◽  
Intervention Program ◽  
Hallux Rigidus ◽  
Therapeutic Management ◽  
Great Toe ◽  
Ovid Medline ◽  
Published Evidence ◽  
Cochrane Database ◽  
Comprehensive Intervention

Background. Hallux rigidus is a chronic, disabling condition of foot characterized by reduced great toe extension. The manual therapy approaches are described theoretically however their practical published evidence has not been analyzed well.Objective. Aim of the present paper was to systematically review the literature available for therapeutic management of the hallux rigidus by identifying and evaluating the randomized controlled trials (RCTs) and non-RCTs.Methods. To view the hallux rigidus and its rehabilitation, a webbased published literature search of Pubmed, Ovid Medline, Science direct, Cochrane Database, PEDro database, CINAHL was conducted for last 35 years in August 2010 using 4 specific keywords “hallux rigidus, physical therapy, chiropractic, and manual therapy” typed in exactly same manner in the search column of the databases.Result. the review finds that there is acute need of the quality studies and RCTs for the manual therapy, chiropractic, or physiotherapeutic management of the hallux rigidus.Conclusion. Review conclude that conservative programs for hallux rigidus consists of comprehensive intervention program that includes great toe mobilization, toe flexor strengthening, sesamoid bones mobilization and long MTP joint. The clinician should put an emphasis on the mobilization program with proper follow up along with comparative studies for rehabilitation of hallux rigidus.

Keller Resection Arthroplasty for Treatment of Hallux Valgus Deformity: Increased Correction with Fibular Sesamoidectomy

2002 ◽  
Vol 23 (8) ◽  
pp. 699-703 ◽  
Author(s):  
Brian G. Donley ◽  
Roderick A. Vaughn ◽  
Kenneth A. Stephenson ◽  
E. Greer Richardson
Keyword(s):  
Hallux Valgus ◽  
Valgus Deformity ◽  
Resection Arthroplasty ◽  
Activity Limitations ◽  
Moderate Pain ◽  
Mild Pain ◽  
Hallux Valgus Deformity

Thirty-eight patients (50 feet) were treated with Keller resection arthroplasties combined with fibular sesamoidectomies. Thirty-six patients were females (48 feet) and two were males (two feet). Their ages ranged from 55 to 87 years and averaged 68.4 years. Preoperative metatarsophalangeal (MTP) angles averaged 34° (range, 10 to 55°) and intermetatarsal (IM) angles averaged 15° (range, 8 to 27°). All patients were evaluated at an average of three years after surgery. An average correction of 18° in the MTP angle and 6° in the IM angle were obtained. At follow-up, 76% of patients had no pain, 14% had mild pain, and 10% had moderate pain; 76% had no activity limitations, 22% had recreational limitations, and 2% had daily limitations. Ninety-five percent of patients were satisfied with the results of their surgery.

Does nerve repair influence the outcome of reconstruction of a digital nail defect using a free composite flap taken from the great toe?

2014 ◽  
Vol 40 (6) ◽  
pp. 583-590 ◽  
Author(s):  
X. Zhang ◽  
C. Chen ◽  
Y. Li ◽  
X. Shao ◽  
W. Guo ◽  
...  
Keyword(s):  
Nerve Repair ◽  
Donor Site ◽  
Digital Nerve ◽  
Great Toe ◽  
Dorsal Branch ◽  
Mean Size ◽  
The Mean ◽  
Repair Group ◽  
Composite Flap

We describe reconstruction of a nail unit defect in the finger using a free composite flap taken from the great toe, comparing the outcome in patients in whom neurorrhaphy between the dorsal digital nerve of the great toe and the dorsal branch of the proper digital nerve of the injured finger was performed to those in which no nerve repair was made. From January 2002 to March 2009, 47 patients with traumatic fingernail defects were treated. Twenty-two patients before February 2005 had no nerve repair and subsequently 25 patients had nerve repair. The mean size of the germinal matrix and sterile matrix defects was 9 × 8 mm, and the mean size of the nail bed flaps was 9 × 9 mm. The mean length of the arteries used for the flap was 2.2 cm. Outcomes were rated. In the nerve repair group, full flap survival was achieved in 24 patients. At the mean follow-up period of 25 months, there were 12 excellent, seven very good, four good, and two fair results. In the comparison group without nerve repair, there were seven excellent, four very good, four good, five fair, and two poor results. Donor site morbidities were similar in both groups. The use of a free composite flap taken from the great toe is a useful technique for reconstructing nail unit defects in the finger. Innervated nail flap reconstructions tended to show better outcomes than those in which no nerve repair was performed. There is no difference in function or donor site between those in whom the nerve was repaired compared with those in whom it was not repaired.

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