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Revision MTP arthrodesis for failed MTP arthroplasty.
Christopher E Gross1, Andrew R Hsu, Johnny Lin
1Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois.
Foot & Ankle Specialist
|September 13, 2013
Summary
Salvage first MTP arthrodesis after failed implant arthroplasty shows high reoperation rates and slower fusion times. However, patients report improved function and satisfaction despite complications, making it a viable option for painful hallux rigidus.
Area of Science:
- Orthopedic Surgery
- Foot and Ankle Surgery
- Reconstructive Surgery
Background:
- Hallux rigidus often requires surgical intervention when conservative treatments fail.
- Arthrodesis is the gold standard, but arthroplasty is sometimes used to preserve motion.
- Failed arthroplasty necessitates salvage first MTP (metatarsophalangeal) joint arthrodesis.
Purpose of the Study:
- To outline methods for MTP joint arthrodesis in salvage situations.
- To evaluate outcomes of salvage MTP arthrodesis following failed implant arthroplasty.
Main Methods:
- Retrospective review of patients undergoing first MTP fusion after failed implant arthroplasty.
- All fusions utilized bone allograft or autograft with internal fixation.
- Clinical and radiographic assessments included the AOFAS MTP-IP questionnaire.
Main Results:
- 11 patients were included, with an average age of 57.
- High reoperation rate (58%) and delayed union (41.7%) were observed.
- Despite complications, all patients showed improved AOFAS MTP-IP scores.
Conclusions:
- Salvage MTP arthrodesis for failed arthroplasties has high patient satisfaction.
- These procedures have higher complication and reoperation rates compared to primary fusions.
- Slower union times and lower AOFAS scores are noted in salvage settings.
