Second-Generation Ceramic First Metatarsophalangeal Joint Replacement for Hallux Rigidus

Area of Science:

• Orthopedic surgery
• Biomaterials science
• Podiatric medicine

Background:

• Limited mid- to long-term data exist for ceramic first metatarsophalangeal (MP) joint replacement in hallux rigidus treatment.
• This study evaluates midterm outcomes of a second-generation ceramic implant for first MP joint arthroplasty.

Purpose of the Study:

• To assess the clinical and radiological results of second-generation ceramic first MP joint implants.
• To determine the implant survival rate and identify complications associated with this specific prosthesis.

Main Methods:

• Retrospective review of 31 feet (24 women) undergoing first MP joint replacement with a second-generation ceramic prosthesis.
• Mean follow-up of 81 months, including clinical assessment (range of motion, AOFAS, Foot Function Index) and radiographic analysis.
• Level IV, case series study design.

Main Results:

• Mean passive range of motion was 32 degrees; mean AOFAS and Foot Function Index scores were 72 and 27, respectively.
• Clinical ratings were poor in 45% of primary procedures; patient satisfaction was 77%.
• Radiolucency, component malalignment, and sinkage were common. Complications included infection and prosthesis fracture, leading to a 16% revision rate. Implant survival at 5, 7, and 9 years was 92%, 85%, and 68%.

Conclusions:

• Second-generation ceramic first MP joint replacement demonstrated suboptimal clinical and radiological outcomes in this series.
• A high revision rate and concerning radiographic findings suggest limitations of this implant for first MP joint arthroplasty.