Comparison of Lesser Toe Proximal Interphalangeal Joint Arthrodesis Versus Resection Arthroplasty: A Randomized...

Area of Science:

• Orthopedics
• Podiatry
• Surgical Outcomes

Background:

• Lesser toe deformities are common and can cause significant pain and functional impairment.
• Surgical correction often involves the proximal interphalangeal (PIP) joint, with arthrodesis (fusion) and resection arthroplasty being common procedures.

Purpose of the Study:

• To compare the operative outcomes of PIP joint arthrodesis versus PIP joint resection arthroplasty for the correction of lesser toe deformities.
• To evaluate differences in pain, function, osseous consolidation, and overall clinical outcomes between the two surgical techniques.

Main Methods:

• A prospective randomized controlled trial involving 37 patients (48 toes) was conducted.
• Patients underwent either PIP joint arthrodesis or resection arthroplasty.
• Outcomes were assessed preoperatively and at 6 weeks and 6 months postoperatively using the numeric rating scale (NRS) and American Orthopedic Foot and Ankle Society (AOFAS) scores.

Main Results:

• Both groups demonstrated significant improvement in outcomes at 6 months postoperatively.
• While osseous consolidation was higher in the arthrodesis group (P=.001), this did not translate to significant clinical differences.
• At 6 months, NRS pain scores were 0 for both groups (P=.669), and AOFAS scores were 83 for arthroplasty and 80 for arthrodesis (P=.879).
• No differences were observed in inflammation or axis correction between the groups.

Conclusions:

• Proximal interphalangeal (PIP) joint arthrodesis and PIP joint resection arthroplasty provide comparable clinical outcomes for lesser toe deformity correction.
• Both procedures result in good to excellent patient outcomes, with no significant clinical advantages of one over the other.
• Radiological evidence of fusion did not correlate with improved clinical results.