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A retrospective cohort study of the BioPro hemiarthroplasty prosthesis
Christine C Salonga1, David C Novicki, Martin M Pressman
1Podiatric Surgery, Yale New Haven Hospital, New Haven, CT 06511, USA.
Insights
First metatarsophalangeal joint hemiarthroplasty using the BioPro Hemi Implant improved joint motion and patient satisfaction. This procedure offers a useful option for treating first metatarsophalangeal joint degeneration with a low complication rate.
Area of Science:
- Orthopedic Surgery
- Podiatric Surgery
- Biomedical Engineering
Background:
- First metatarsophalangeal (MTP) joint degeneration is a common condition causing pain and functional limitation.
- Hemiarthroplasty is a surgical option for MTP joint arthritis, aiming to preserve joint function.
- The BioPro Hemi Implant is one such device used for MTP joint hemiarthroplasty.
Purpose of the Study:
- To evaluate the clinical outcomes of first metatarsophalangeal joint hemiarthroplasty using the BioPro Hemi Implant.
- To assess the impact of the procedure on joint range of motion, radiographic parameters, and patient-reported outcomes.
- To determine the complication rate associated with this specific hemiarthroplasty technique.
Main Methods:
- Retrospective review of 79 procedures in 76 patients who underwent first MTP joint hemiarthroplasty with the BioPro Hemi Implant.
- Data collection included patient demographics, surgical technique (with or without long flexor transfer), and radiographic measurements (dorsiflexion, plantarflexion, first intermetatarsal angle, first-ray elevatus).
- Postoperative outcomes assessed included gait, hallux purchase, cosmesis, shoe wear, pain relief, patient satisfaction, and the American College of Foot and Ankle Surgeons Universal Evaluation score.
Main Results:
- Significant improvements were observed in first MTP joint dorsiflexion (36.13° to 56.92°) and plantarflexion (2.71° to 9.05°).
- Radiographic improvements included a decrease in the first intermetatarsal angle (8.65° to 8.41°) and prevalence of first-ray elevatus (65.82% to 55.70%).
- High rates of patient satisfaction (86.08%), normal hallux purchase (93.67%), and ability to wear conventional shoes (53.16%) were reported, with a mean postoperative American College of Foot and Ankle Surgeons Universal Evaluation score of 94.00.
Conclusions:
- First MTP joint hemiarthroplasty with the BioPro Hemi Implant demonstrates favorable outcomes in terms of joint mobility and radiographic alignment.
- The procedure leads to significant improvements in patient-reported satisfaction and functional ability, including pain relief and shoe wear.
- The BioPro Hemi Implant is a useful option for managing first MTP joint degeneration, with a low overall complication rate of 10.13%.
Abstract:
We reviewed the outcomes of 79 procedures in 76 patients who underwent first metatarsophalangeal joint hemiarthroplasty. The cohort included 23 men (2 bilateral cases) and 53 women (1 bilateral case), with a mean age of 59.6 +/- 11.05 years and a mean follow-up of 2.91 years (range, 1.6-4.5 years). Hemiarthroplasty with the BioPro Hemi Implant (BioPro, Inc., Port Huron, MI) was undertaken in all cases, and 34 (43.04%) of the procedures involved long flexor transfer to the proximal phalanx. Mean first metatarsophalangeal joint dorsiflexion increased from 36.13 degrees +/- 17.89 degrees to 56.92 degrees +/- 9.82 degrees (P < .0001), plantarflexion increased from 2.71 degrees +/- 8.43 degrees to 9.05 degrees +/- 4.52 degrees (P < .0001), the first intermetatarsal angle decreased from 8.65 degrees +/- 1.17 degrees to 8.41 degrees +/- 0.90 degrees (P = .0009), and the prevalence of first-ray elevatus went from 52 (65.82%) to 44 (55.70%) (P = .0047). Postoperative prevalences included: antalgic gait, 11 (13.92%); normal hallux purchase, 74 (93.67%); satisfaction with the appearance of the great toe, 49 (62.03%); ability to wear conventional shoes, 42 (53.16%); freedom from pain, 45 (56.96%); and satisfaction or high level of satisfaction with the outcome, 68 (86.08%). The mean postoperative American College of Foot and Ankle Surgeons Universal Evaluation score was 94.00 (range, 44-100). Eight (10.13%) cases experienced complications: 2 severe pain (1 required implant removal), 1 sesamoiditis, 1 extensor hallucis longus contracture, 1 hallux subluxation and 1 dislocation, and 2 misaligned implants. Based on these results, use of the BioPro hemi-implant is a useful option for the treatment of first metatarsophalangeal joint degeneration.
