Comparative study of dorsiflexion closing wedge osteotomy of the metatarsal head and osteochondral autologous transplantation for Freiberg disease treatment: A multicenter analysis.

Autor: Incesoy MA; Department of Orthopedics, Bezmialem Vakif University Faculty of Medicine, Istanbul, Turkey. Electronic address: alperincesoy@gmail.com., Pehlivanoglu G; Departmant of Orthopaedics and Traumatology, Health Science University Baltalimani Bone Diseases Education and Research Hospital, Istanbul 34467, Turkey., Kaya HB; Department of Orthopedics, Bezmialem Vakif University Faculty of Medicine, Istanbul, Turkey., Geckalan MA; Department of Orthopedics, Bezmialem Vakif University Faculty of Medicine, Istanbul, Turkey., Ozdemir AA; Department of Medical Education, Mersin University, Faculty of Medicine, Mersin, Turkey., Yildiz F; Department of Orthopedics, Bezmialem Vakif University Faculty of Medicine, Istanbul, Turkey., Uzer G; Department of Orthopedics, Bezmialem Vakif University Faculty of Medicine, Istanbul, Turkey.
Jazyk: angličtina
Zdroj: The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons [J Foot Ankle Surg] 2024 Oct 26. Date of Electronic Publication: 2024 Oct 26.
DOI: 10.1053/j.jfas.2024.09.009
Abstrakt: Freiberg disease (FD) is a condition characterized by osteochondrosis affecting the metatarsal heads, with the second metatarsal head being the most commonly affected. Dorsiflexion Closing Wedge Osteotomy of the Metatarsal Head (DCWMO) has been conventionally employed, whereas Osteochondral Autologous Transplantation (OAT) represents a more recent technique with restricted comparative research. This study aimed to compare the outcomes of DCWMO and OAT for treating Freiberg disease (FD). Groups were established among two institutions. Institution-1 has made the treatment with OAT (8 patients) and Institution-2 has made the treatment with DCWMO (8 patients). The primary outcomes collected, including complications, range of motion, length of the metatarsal, American-Orthopaedic-Foot-and-Ankle-Society-lesser MTP-interphalangeal (AOFAS-LMI) score, visual-analog-scale (VAS), Foot-and-Ankle-Disability (FADI) score, and Short-Form-12 (SF-12), were all compared. The Sport-FADI and activity-FADI scores at final follow-up were significantly greater in the OAT group than in the DCWMO group (94.04 vs 84.75 and 97 vs 92, P = 0.021 and P = 0.04, respectively), whereas plantarflexion at final follow-up was significantly lower in the DCWMO group than in the OAT group (43.13 vs 6.88 degrees, P < 0.001). The AOFAS-LMI score at final follow-up was significantly greater in the DCWMO group than in the OAT group (86.75 vs 75.38, P = 0.013). In conclusion, this study highlights the effectiveness of both OAT and DCWMO in treating Freiberg's disease, as evidenced by significant postoperative improvements in various functional scores, including AOFAS-LMI, VAS and FADI. Notably, OAT demonstrated favorable outcomes in SFADI and AFADI and plantarflexion ROM, while DCWMO led to improved the AOFAS-LMI score. Level of Evidence: Level 3.
Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interest.
(Copyright © 2024. Published by Elsevier Inc.)
Databáze: MEDLINE
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