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.

The Use of a Grommet Bone Liner for Flexible Hinge Implant Arthroplasty of the Great Toe

Foot & Ankle ◽  
1991 ◽  
Vol 12 (3) ◽  
pp. 149-155 ◽  
Author(s):  
Alfred B. Swanson ◽  
Genevieve de Groot Swanson ◽  
B. Kent Maupin ◽  
Sho-min Shi ◽  
John G. Peters ◽  
...  
Keyword(s):  
Metatarsophalangeal Joint ◽  
Functional Results ◽  
Silicone Implants ◽  
Great Toe ◽  
First Metatarsophalangeal Joint ◽  
Flexible Hinge ◽  
Press Fit ◽  
Bone Response ◽  
Metatarsophalangeal Joints

Press-fit titanium grommets were developed to shield flexible hinged silicone implants used for arthroplasty of the radiocarpal, metacarpophalangeal, and metatarsophalangeal joints. Since 1985, 179 titanium circumferential grommets were used in 90 first metatarsophalangeal joints with excellent, pain-free, functional results and favorable bone response around the implant stems and at the bone-grommet interface. There were no complications due to particulate reactivity, implant fracture, or grommet fracture. The use of circumferential titanium grommets appears to be a safe and effective method to improve the long-term durability of flexible hinge implant arthroplasty of the first metatarsophalangeal joint.

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.

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