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First metatarsophalangeal joint arthrodesis - Do joint configuration and preparation technique matter?
D Mahadevan1, M T Korim1, A Ghosh1
1Leicester Orthopaedics, University Hospitals of Leicester, Leicester General Hospital, LE5 4PW, UK.
Background:
The purpose of this study was to investigate the influence of joint configuration and preparation on first metatarsophalangeal (MTPJ) union rates.
Methods:
We performed a retrospective analysis of first MTPJ arthrodeses undertaken in our institution. Clinical notes, radiographs and postal questionnaires were used to determine outcome.
Results:
Two hundred first MTPJ arthrodeses (172 patients) were included in the analysis (34 male: 138 female; mean age 62 yr). The overall union rate was 93.5%. Union was achieved in 109/118 MTPJs (92.4%) prepared in the flat-on-flat configuration and in 78/82 (95%) prepared in the ball-and-socket configuration (p=0.438). Higher union rates favoured low-velocity joint preparation [using rongeur only 21/21 (100%), rongeur and burr 26/27 (96.3%) and conical reamer 31/34 (91.2%)] but this did not reach statistical significance (p=0.317). There was a 95% satisfaction rate with surgery but male patients were less satisfied (p=0.031).
Conclusion:
Union rates were not influenced by joint configuration or preparation techniques.
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