Long-Term Follow-up of Arthrodesis vs Total Joint Arthroplasty for Hallux Rigidus
| Autor: | Colin E Thomson, Robbie Ray, Oliver D. Stone, J N Alastair Gibson |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Metatarsophalangeal Joint
medicine.medical_specialty Joint arthroplasty Long term follow up Arthrodesis medicine.medical_treatment law.invention 03 medical and health sciences Hallux rigidus 0302 clinical medicine Randomized controlled trial law Hallux Rigidus medicine Humans Orthopedics and Sports Medicine Longitudinal Studies Arthroplasty Replacement Pain Measurement Retrospective Studies Salvage Therapy 030222 orthopedics business.industry Gold standard 030229 sport sciences medicine.disease Arthroplasty Surgery Treatment Outcome business Follow-Up Studies |
| Zdroj: | Foot & Ankle International. 38:375-380 |
| ISSN: | 1944-7876 1071-1007 |
| DOI: | 10.1177/1071100716682994 |
| Popis: | Background: The optimal operative management of hallux rigidus is still a matter for debate among surgeons. Despite arthrodesis widely considered to be the gold standard treatment, many surgeons advocate arthroplasty as a suitable alternative. There are, however, few long-term or high-quality studies evaluating these modalities. We present the 15-year follow-up of a randomized controlled trial. Methods: This data is the follow-up to the original study published in 2005. In the original study, 63 patients (77 toes) were recruited to and randomized to have either metatarsophalangeal joint (MTPJ) arthrodesis or arthroplasty. The primary outcome measure was a decrease in pain on a visual analog scale (VAS) at 24 months. In the present study, data were available for all surviving patients (52 patients, 66 toes). Data were collected in the form of satisfaction scores, VAS for pain, the VAS foot and ankle and survivorship data. Results: The results of the original study demonstrated that pain relief was greater following arthrodesis at 2 years. At 15 years, patients with an arthrodesis experienced less pain and were more satisfied compared to those with an arthroplasty. No functional differences were seen between these 2 groups. There were more revisions in the arthroplasty group. Conclusion: Despite the hope of better function, less pain, and greater satisfaction from MTPJ replacement, this was not found in our patient population. The long-term results of our study showed that arthrodesis outperformed arthroplasty. If an arthroplasty failed, then salvage was likely to be technically difficult, with significant potential for complications. Level of Evidence: Level I, randomized controlled trial. |
| Databáze: | OpenAIRE |
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