title: Prospective analysis of a first MTP total joint replacement. Evaluation by bone mineral densitometry, pedobarography, and visual analogue score for pain.
abstract: BACKGROUND
  We hypothesized that a total replacement of the first metatarsophalangeal joint (MTP-1) would alter the walking pattern with medialisation of the ground reaction force (GRF) of the foot and subsequently cause an increase in bone mineral density (BMD) in the medial metatarsal bones and a decline of BMD in the lateral metatarsal bones.
  
  
  METHODS
  Twelve patients receiving total joint replacements (Roto-Glide(®)) of MTP-1 were enrolled in a prospective cohort. BMD and pedobarography of the heel bone and the metatarsal heads were performed preoperatively and at least 12 months postoperatively.
  
  
  RESULTS
  BMD in the lateral metatarsals and GRF under the lateral column of the operated feet decreased significantly on the operated feet.
  
  
  CONCLUSIONS
  Total joint replacement of MTP-1 tends to reduce GRF under the lateral column of the foot causing a corresponding decline in BMD and pedobarographic measures. Our findings support the further use of the Roto-Glide(®) prosthesis for osteoarthritis of the first metatarsophalangeal joint.
authors.affiliation: Department of Orthopaedic Surgery, Frederiksberg Hospital, University Hospitals of the Capitol Region of Denmark, DK 2200 Copenhagen N, Denmark. evawetke@hotmail.com
authors.forename: Eva
authors.initials: E
authors.lastname: Wetke
authors.forename: Bo
authors.initials: B
authors.lastname: Zerahn
authors.forename: Hakon
authors.initials: H
authors.lastname: Kofoed
mesh_terms: D019643:Arthroplasty, Replacement; D001696:Biomechanical Phenomena; D015519:Bone Density; D005260:Female; D005528:Foot / Q000502:physiology; D006801:Humans; D008297:Male; D008683:Metatarsophalangeal Joint / Q000502:physiology* / Q000601:surgery*; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies