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Area of Science:

  • Orthopedic Surgery
  • Foot and Ankle Surgery
  • Biomechanical Engineering

Background:

  • First metatarsophalangeal joint (MTPJ) arthrodesis is a frequent procedure in foot and ankle surgery.
  • Identifying risk factors for reoperation is crucial for improving patient outcomes.
  • This study investigates patient, radiologic, and surgical variables associated with reoperation after MTPJ arthrodesis.

Purpose of the Study:

  • To explore patient-related risk factors for reoperation after first MTPJ arthrodesis.
  • To identify radiologic risk factors associated with reoperation following first MTPJ arthrodesis.
  • To determine surgery-related risk factors impacting reoperation rates in first MTPJ arthrodesis.

Main Methods:

  • Retrospective review of all first MTPJ arthrodesis operations at Helsinki University Hospital (2010-2020).
  • Assessment of patient-related risk factors for reoperation.
  • Propensity-matched analysis comparing reoperated and non-reoperated cases for radiologic and surgery-related factors.

Main Results:

  • A total of 3911 primary operations and 453 reoperations were analyzed.
  • Increased reoperation risk was linked to preoperative grade I arthrosis (Coughlin and Shurnas) and greater hallux valgus angle.
  • Decreased reoperation risk was associated with snap-off screw fixation, female sex, older age, and greater change in hallux valgus angle.

Conclusions:

  • Multiple patient, radiologic, and surgical factors are associated with reoperation risk after first MTPJ arthrodesis.
  • Findings highlight potential predictors for reoperation, aiding in surgical planning and patient counseling.
  • The retrospective nature of the study precludes definitive causal inferences.