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A new surgical technique for treating bilateral Freiberg disease
Kaori Hayashi1, Mitsuo Ochi, Yuji Uchio
1Department of Orthopaedics, Shimane Medical University, Shimane, Japan.
Summary
This study introduces osteochondral plug transplantation as a novel surgical technique for treating late-stage Freiberg disease, effectively restoring metatarsophalangeal joint function and enabling a return to athletic activities.
Area of Science:
- Orthopedics
- Sports Medicine
- Regenerative Medicine
Background:
- Freiberg disease is a rare condition affecting the metatarsophalangeal joint, often presenting challenges in satisfactory treatment, particularly in late stages.
- Current treatment options for advanced Freiberg disease may not fully restore joint function or enable a return to high-impact activities.
Observation:
- This study details a novel surgical technique involving osteochondral plug transplantation for late-stage Freiberg disease (Smillie's stage IV).
- The procedure harvests an osteochondral plug from the ipsilateral knee's non-weight-bearing femoral condyle.
- A stage II lesion was also treated using retrograde drilling, demonstrating varied approaches based on disease severity.
Findings:
- Osteochondral plug transplantation in a stage IV Freiberg disease patient resulted in excellent clinical and morphologic outcomes one year post-surgery.
- The patient experienced complete pain relief during running and resumed full athletic activities.
- Arthroscopic intervention showed good results in early stages, complementing the transplantation technique for later stages.
Implications:
- Osteochondral plug transplantation presents a promising surgical solution for restoring metatarsophalangeal joint function in advanced Freiberg disease.
- This technique may enable patients to return to pre-disease levels of athletic performance.
- Further research into this technique could enhance treatment paradigms for this challenging condition.