Treatment of hallux rigidus with percutaneous metatarsophalangeal arthrodesis: a case series with a minimum follow-up of 2 years.

Autor: Ferreira GF; Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, Prevent Senior, São Paulo, Brazil.; Member of Minimally Invasive Foot Ankle Society (MIFAS), Merignac, France.; Instituto Vita, São Paulo, Brazil., Pedroso JP; Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, Prevent Senior, São Paulo, Brazil., Nunes GA; Member of Minimally Invasive Foot Ankle Society (MIFAS), Merignac, France., Del Vecchio JJ; Board Members of Minimally Invasive Foot Ankle Society (MIFAS), Merignac, France., Lewis TL; Guy's and St Thomas' NHS Foundation Trust, London, UK., Mattos E Dinato MC; Department of Orthopaedics, Rheumatology and Traumatology, State University of Campinas (UNICAMP), Campinas, São Paulo, Brazil.; Instituto Vita, São Paulo, Brazil., Nogueira VB; Hospital Municipal Ouro Verde, Campinas, Brazil., Filho MVP; Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, Prevent Senior, São Paulo, Brazil. miguel.viana.filho@gmail.com.; Instituto Vita, São Paulo, Brazil. miguel.viana.filho@gmail.com.
Jazyk: angličtina
Zdroj: Archives of orthopaedic and trauma surgery [Arch Orthop Trauma Surg] 2023 Nov; Vol. 143 (11), pp. 6521-6526. Date of Electronic Publication: 2023 Jun 26.
DOI: 10.1007/s00402-023-04948-1
Abstrakt: Background: Percutaneous metatarsophalangeal arthrodesis is an option for the treatment of hallux rigidus in more advanced cases. The aim of this study was to investigate the clinical and radiographic results at least 2 years after percutaneous metatarsophalangeal arthrodesis in patients with hallux rigidus.
Methods: This is a case series of consecutive patients undergoing percutaneous metatarsophalangeal arthrodesis in patients with hallux rigidus grades III and IV with a minimum of 24 months of clinical and radiographic follow-up. The primary outcome was clinical assessment using the Visual Analog Scale for Pain (VAS). Secondary outcomes included American Orthopedic Foot & Ankle Society (AOFAS) score, patient satisfaction, complications, and bone healing (radiographic analysis).
Results: Between August 2017 and February 2020, 29 feet (24 patients) underwent percutaneous metatarsophalangeal arthrodesis. The mean follow-up was 38.4 (range 24-54) months. There was an improvement in the pain (VAS) from 7.8 to 0.6 (p < 0.001) and in the AOFAS score from 49.9 to 83.6 (p < 0.001). There was a rate of bone union of 82.8% and screw removal of 13.8%. All patients considered the result to be excellent or good.
Conclusion: The treatment of grade III and IV hallux rigidus with percutaneous metatarsophalangeal arthrodesis demonstrated high patient satisfaction and significantly improves in clinical outcomes but the nonunion rate was higher than reported outcomes for open 1st metatarsophalangeal joint arthrodesis.
Level of Evidence: IV, case series.
(© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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