Joint Preparation and Ray Shortening in Arthroscopic Versus Open First Metatarsophalangeal Fusion: A Cadaver Study
| Autor: | Eildar Abyar, Bradley Alexander, Nicholas A Andrews, Gean C. Viner, Haley McKissack, Ashish Shah |
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| Rok vydání: | 2020 |
| Předmět: |
joint preparation
business.industry Radiography mtp fusion General Engineering 030204 cardiovascular system & hematology Phalanx ray shortening 03 medical and health sciences Orthopedics 0302 clinical medicine Cadaver Metatarsophalangeal fusion Medicine Analysis software arthroscopic business Nuclear medicine Joint (geology) 030217 neurology & neurosurgery Second ray Fixation (histology) |
| Zdroj: | Cureus |
| ISSN: | 2168-8184 |
| DOI: | 10.7759/cureus.9633 |
| Popis: | Purpose This study compares the amount of joint preparation and first ray shortening following first metatarsophalangeal (MTP) joint fusion utilizing open conical reaming versus arthroscopic technique. Methods Ten below-knee cadaver specimens were randomly assigned to undergo either open or arthroscopic first MTP fusion. Following fixation, first ray length measurements were obtained from pre-operative and post-operative radiographs and were used to determine first ray shortening. Additionally, the ratio of first ray length to second ray length was calculated both pre-operatively and post-operatively and compared between the two approaches. All ankles were then completely dissected, and prepared surface areas were demarcated. ImageJ photo analysis software (National Institutes of Health, Bethesda, MD, USA) was used to calculate the percentage of prepared and unprepared cartilage of each articular surface of each specimen. Results Overall, the open approach resulted in 99.3% ± 1.6% joint surface preparation, whereas the arthroscopic approach yielded 92.9% ± 7.2% (p = 0.089). On average, the head of the first metatarsal was significantly more prepared with the use of the open approach (99.5% ± 1.1%) than with the arthroscopic approach (96.6% ± 1.5%) (p = 0.008). However, with respect to the base of the phalanx, the average difference in preparation between the arthroscopic approach and the open approach was not statistically significant (90.0% ± 12.8% vs. 99.0% ± 2.2%; p = 0.160). The average amount of first ray shortening in the arthroscopic approach was 2.2 ± 1.8 mm compared to 2.1 ± 3.2 mm in the open approach (p = 0.934). The average change in the first to second ray length ratio was 0.02 for both approaches (p = 0.891). Conclusion Arthroscopic first MTP fusion can be used to achieve joint preparation comparable to open technique while maintaining first ray length. |
| Databáze: | OpenAIRE |
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