Revision of Implant to Great Toe Fusion: Did We “Burn a Bridge” With a Synthetic Implant Hemiarthroplasty?

Foot & Ankle Orthopaedics

MarkGlazebrook¹ 

关键词: synthetic cartilage implant;    hemiarthroplasty;    first metatarsophalangeal joint;    arthrodesis;    revision;    outcomes;    VAS pain;    FAAM;    SF-36;   

DOI  :  10.1177/2473011417S000044

学科分类：医学（综合）

来源: Sage Journals

【 摘 要 】

Category:Midfoot/ForefootIntroduction/Purpose:A prospective, randomized, non-inferiority clinical trial demonstrated that first metatarsophalangeal joint (MTPJ1) hemiarthroplasty with a synthetic polyvinyl alcohol hydrogel implant (Cartiva®) had equivalent pain relief and functional outcomes to MTPJ1 arthrodesis at 2 years. Despite 91% success, there was a 9.2% rate of implant removal and conversion to fusion. Other implants with more bone resection have demonstrated poorer outcomes after conversion to fusion than if a primary arthrodesis was performed. Since bone loss with synthetic cartilage implant hemiarthroplasty is minimal, we hypothesized that outcomes following implant removal and conversion to fusion would be similar to those following primary arthrodesis. We determined the outcomes of revision of synthetic implant hemiarthroplasty of the great toe to MTPJ1 arthrodesis and compared these outcomes to the primary arthrodesis cohort.Methods:In the original pivotal trial, 152 patients >/=18 years dia...

【 授权许可】

CC BY