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Arthroscopic Treatment of Freiberg Disease - Case Report
Pedro Atilano Carvalho1, João Teixeira1, Filipa Oliveira1
1Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal.
Abstract:
Freiberg disease is a rare condition whose diagnosis requires a high clinical suspicion. Avascular necrosis of the metatarsal head progresses with articular collapse, leading to forefoot pain and limitation of the daily activities. Several surgical techniques have been described to address the disease, and since it is usually diagnosed in later-stages, most of them include joint-destructive procedures. The use of arthroscopy on the small joint of the foot has arisen in the last few years, but its application in Freiberg disease is still scant. Joint-preserving procedures have been advocated for cases of early-stage disease, aiming to relieve symptoms while preventing the progression of the disease. In the present report, we describe a successful treatment of a 12-year-old patient with early-stage Freiberg disease using core decompression and bone marrow graft through a minimally-invasive approach assisted by arthroscopy.
Insights
This study presents a minimally-invasive arthroscopic treatment for early-stage Freiberg disease, a rare condition causing foot pain. The successful core decompression and bone marrow graft preserved the joint, offering a new approach for young patients.
Area of Science:
- Orthopedics
- Foot and Ankle Surgery
- Regenerative Medicine
Background:
- Freiberg disease involves avascular necrosis of the metatarsal head, leading to pain and functional limitations.
- Late diagnosis often necessitates joint-destructive surgeries, while early-stage joint-preserving options are less explored.
- Arthroscopic techniques for small foot joints are emerging but infrequently applied to Freiberg disease.
Purpose of the Study:
- To describe a successful minimally-invasive treatment for early-stage Freiberg disease.
- To evaluate the efficacy of arthroscopically assisted core decompression and bone marrow grafting.
- To highlight a joint-preserving approach for pediatric patients with Freiberg disease.
Main Methods:
- A 12-year-old patient with early-stage Freiberg disease was treated.
- A minimally-invasive surgical approach utilizing arthroscopy was employed.
- Core decompression and bone marrow grafting were performed to preserve the affected metatarsal head.
Main Results:
- The patient experienced successful treatment of early-stage Freiberg disease.
- The minimally-invasive, arthroscopically assisted procedure preserved the joint.
- Symptoms were relieved, and daily activity limitations were addressed.
Conclusions:
- Arthroscopically assisted core decompression and bone marrow grafting represent a viable joint-preserving option for early-stage Freiberg disease.
- This minimally-invasive technique offers a promising alternative to traditional joint-destructive procedures.
- Further research is warranted to establish the long-term outcomes of this approach in pediatric populations.
