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J Foot Ankle Surg. 2017 Sep - Oct;56(5):1052-1057. doi: 10.1053/j.jfas.2017.05.010.

Ten-Year Follow-Up of Metatarsal Head Resurfacing Implants for Treatment of Hallux Rigidus.

Author information

1
Chief Resident, Foot and Ankle Surgery Division, Department of Orthopaedics, John Peter Smith Hospital, Fort Worth, TX. Electronic address: henryhilarioDPM@gmail.com.
2
Assistant Professor, Department of Orthopaedics, John Peter Smith Hospital, University of North Texas Health Science Center, Fort Worth, TX.
3
Associate Professor and Chair, Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, Fort Worth, TX.
4
Professor, Department of Orthopaedics, John Peter Smith Hospital, University of North Texas Health Science Center, Fort Worth, TX.

Abstract

Controversy remains regarding the use of arthroplasty versus arthrodesis in the surgical treatment of late-stage hallux rigidus. The purpose of our retrospective study was to report the long-term follow-up results of the metatarsal head resurfacing implant used for hemiarthroplasty. The patient assessments were conducted using the American Orthopaedic Foot and Ankle Society (AOFAS) metatarsophalangeal clinical rating system and a satisfaction questionnaire. A total of 59 consecutive implantations were performed from January 2005 to December 2009 at our institution. Of the 59 patients, 2 had died and 12 were lost to follow-up, for a 76.3% follow-up rate (45 of 59 procedures) at a mean of 117.67 (range 96 to 143) months. The mean overall AOFAS scale score was 90.6 ± 7.6. The AOFAS pain scale score was 37.78 ± 4.71. One implant was removed, and all remaining patients were happy with their outcome and would repeat the procedure on their other foot, if needed. A subset of patients from a previous mid-term study at our institution showed no significant change in the AOFAS scale scores. Of these 32 patients, 30 (93.75%) were available for follow-up examination at a mean of 122.62 (range 96 to 143) months. We were able to obtain long-term results for 32 implants (30 patients), resulting in a 10-year follow-up rate of 93.7%. With the minimal resection required for this implant, salvage arthrodesis remains a viable option if revision is needed. The surgical treatment of late-stage hallux rigidus with metatarsal head resurfacing allows for low-risk and excellent outcomes at long-term follow-up point.

KEYWORDS:

HemiCAP(®); arthrodesis; hallux limitus; hallux rigidus; metatarsophalangeal joint

PMID:
28842091
DOI:
10.1053/j.jfas.2017.05.010
[Indexed for MEDLINE]

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