Treatment of first metatarsophalangeal joint arthritis using hemiarthroplasty with a synthetic cartilage implant or arthrodesis: A comparison of operative and recovery time

Foot Ankle Surg. 2018 Oct;24(5):440-447. doi: 10.1016/j.fas.2017.05.002. Epub 2017 May 29.

Abstract

Background: First metatarsophalangeal joint (MTPJ1) hemiarthroplasty using a novel synthetic cartilage implant was as effective and safe as MTPJ1 arthrodesis in a randomized clinical trial. We retrospectively evaluated operative time and recovery period for implant hemiarthroplasty (n=152) and MTPJ1 arthrodesis (n=50).

Methods: Perioperative data were assessed for operative and anaesthesia times. Recovery and return to function were prospectively assessed with the Foot and Ankle Ability Measure (FAAM) Sports and Activities of Daily Living (ADL) subscales and SF-36 Physical Functioning (PF) subscore.

Results: Mean operative time for hemiarthroplasty was 35±12.3min and 58±21.5min for arthrodesis (p<0.001). Anaesthesia duration was 28min shorter with hemiarthroplasty (p<0.001). At weeks 2 and 6 postoperative, hemiarthroplasty patients demonstrated clinically and statistically significantly higher FAAM Sport, FAAM ADL, and SF-36 PF subscores versus arthrodesis patients.

Conclusion: MTPJ1 hemiarthroplasty with a synthetic cartilage implant took less operative time and resulted in faster recovery than arthrodesis.

Level of evidence: III, Retrospective case control study.

Keywords: Anaesthesia; FAAM; First metatarsophalangeal joint; Hallux rigidus; Operative time; Osteoarthritis; Recovery time; Synthetic cartilage implant.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Arthritis / diagnosis
  • Arthritis / surgery*
  • Arthrodesis / methods*
  • Cartilage / transplantation*
  • Follow-Up Studies
  • Hallux / diagnostic imaging
  • Hallux / surgery*
  • Hemiarthroplasty / methods*
  • Humans
  • Metatarsophalangeal Joint / diagnostic imaging
  • Metatarsophalangeal Joint / surgery*
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome