title: Arthroscopic surgery of the metatarsophalangeal first joint.
abstract: Arthroscopic surgery of the metatarsophalangeal first joint was used to treat a dorsal impingement syndrome of the hallux by removing the dorsally located osteophytes. Also, osteochondritis dissecans, painful sesamoid bones resistant to conservative therapy, and hallux rigidus were arthroscopically treated in a prospective study enrolling 24 consecutive patients. Seventeen patients were high-level athletes. Pain, swelling, sports, and work involvement were recorded. The operative technique is described. There was one persistent loss of sensitivity of the hallux. In the dorsal impingement group, 8 of 12 patients had a good or excellent result after a minimum follow-up of 2 years. In patients with osteochondritis dissecans, 3 of 4 showed good or excellent results. In hallux rigidus and sesamoid bone removal the results were less favorable. As in all arthroscopic procedures there was a fast rehabilitation and work resumption. Especially in athletes arthroscopically, treatment of a dorsal impingement syndrome or osteochondritis dissecans can be recommended because of the diminished chance of scar fibrosis.
authors.affiliation: Department of Orthopaedic Surgery, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: C N
authors.initials: CN
authors.lastname: van Dijk
authors.forename: K M
authors.initials: KM
authors.lastname: Veenstra
authors.forename: B C
authors.initials: BC
authors.lastname: Nuesch
mesh_terms: D000293:Adolescent; D000328:Adult; D001182:Arthroscopy; D004724:Endoscopy; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000601:surgery; D008297:Male; D008683:Metatarsophalangeal Joint / Q000601:surgery*; D008875:Middle Aged; D016896:Treatment Outcome