title: Interpositional arthroplasty of the first metatarsophalangeal joint using a regenerative tissue matrix for the treatment of advanced hallux rigidus: 5-year case series follow-up.
abstract: BACKGROUND
  Painful osteoarthritis of the first metatarsophalangeal (MTP) joint, known as hallux rigidus, can be difficult to treat in young and active patients that who fail conservative treatment. The purpose of this study is to report the 5-year follow-up of a joint preservation technique for the treatment of advanced hallux rigidus.
  
  
  METHODS
  Preservation of the first MTP joint is performed using a human acellular dermal regenerative matrix as an interpositional arthroplasty graft. A retrospective chart review was performed and compared with follow-up modified American Orthopedic Foot and Ankle scores (AOFAS) obtained by telephone. Of the first 9 consecutive patients in the original study cohort, 6 patients were available for follow-up. The outcome measures include AOFAS modified for pain and function, reoperation rates, and overall satisfaction with the procedure.
  
  
  RESULTS
  The average follow-up was 5.43 years. No patient had a subsequent fusion or additional procedure performed on their first MTP joint. Average preoperative modified AOFAS were 38 (range, 34 to 43). Average postoperative AOFAS were 65.8 (range, 58 to 68). All patients were satisfied with their results.
  
  
  CONCLUSIONS
  Interpositional arthroplasty of the first MTP joint using a regenerative tissue matrix has led to reliable pain relief and preserved function at an average follow-up of 5.4 years in 6 patients. The authors recommend this technique to active patients with advanced hallux rigidus who want to delay a fusion of their first MTP joint.
authors.affiliation: Orthopedic Foot & Ankle Center, Westerville, OH 43082, USA. ofacresearch@orthofootankle.com
authors.forename: Christopher F
authors.initials: CF
authors.lastname: Hyer
authors.forename: Jaymes D
authors.initials: JD
authors.lastname: Granata
authors.forename: Gregory C
authors.initials: GC
authors.lastname: Berlet
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Lee
mesh_terms: D062088:Acellular Dermis; D000328:Adult; D000368:Aged; D001178:Arthroplasty / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D020859:Hallux Rigidus / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008683:Metatarsophalangeal Joint / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D017060:Patient Satisfaction; D012189:Retrospective Studies; D016038:Skin Transplantation / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome