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Foot Ankle Surg. 2017 Sep;23(3):157-162. doi: 10.1016/j.fas.2016.08.008. Epub 2016 Sep 9.

A prospective 24 months follow-up of a three component press-fit prosthesis for hallux rigidus.

Author information

1
Medisch Centrum Alkmaar, Alkmaar, The Netherlands. Electronic address: wassinksander@hotmail.com.
2
Medisch Centrum Alkmaar, Alkmaar, The Netherlands.
3
Linksfield Medical Centre, Johannesburg, South Africa.
4
Hospital clinico y provincial Unidad de Pie y Tobillo, Barcelona, Spain.
5
Nemocnice Havlíčkův Brod, Havlíčkův Brod, Czech republic.
6
VUmc, MOVE Research Institute, Amsterdam, The Netherlands.

Abstract

BACKGROUND:

The aim of this study was to evaluate the results following total first metatarsophalangeal (FMTP) joint replacement arthroplasty using a modular three component press fit prosthesis at two year follow up.

METHODS:

All patient data was collected in a prospective way in four study centres. Both preoperative and postoperative evaluation consisted of an assessment using the AOFAS-HMI score, visual analogue scale for pain, evaluation of the range of motion and patient satisfaction scores. Postoperative X-rays were reviewed for loosening and radiolucency up to two years.

RESULTS:

Fifty-five feet were available for analysis at 24 months. Two implants were removed during the study. Six more feet had additional surgery due to stiffness or malalignment. Postoperative AOFAS-HMI scores improved significantly by 32.4 points at two year follow-up (p<0.001). The visual analogue scale for pain improved significantly from 6.8 (std 1,6) preoperatively to 1.6 (std 1,9) postoperatively (p<0.0001). Mean dorsiflexion improved from 12.6 (std 10,1) degrees preoperatively to 31.2 (std 16,8) degrees postoperatively. Eighty-seven percent of patients were moderately to well satisfied with the end result. Eighteen prostheses showed radiolucency at 24 months.

CONCLUSION:

Implantation of a Metis® modular three component press fit prosthesis for the metatarsophalangeal joint in hallux rigidus shows significant improvement in AOFAS-HMI scores and a decrease in pain. Concerns remain with regard to early reoperation rate (14.5%) and long term survival of the implant. Future studies will have to address these aspects.

KEYWORDS:

Case series; First metatarsophangeal joint replacement; Hallux rigidus; Level IV clinical evidence; Metis

PMID:
28865583
DOI:
10.1016/j.fas.2016.08.008
[Indexed for MEDLINE]

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