title: Successful arthrodesis of the first metatarsophalangeal joint in patients with inflammatory and noninflammatory arthritis: a comparative analysis.
abstract: Arthrodesis of the first metatarsophalangeal (MTP) joint has been a reliable treatment option for end-stage osteoarthritis (OA) and rheumatoid arthritis (RA). The disease process is very different between these 2 types of degeneration. It is unknown whether first MTP fusions performed for each disease process will heal the same or differently. The purpose of the present study was to compare the fusion rate and interval to fusion between patients with first MTP OA and those with RA. The present study was an institutional review board-approved retrospective radiographic and medical record review funded by a not-for-profit educational research grant. The demographic and clinical variables were collected and compared between the 2 groups. A total of 155 first MTP fusion procedures for OA and RA were analyzed. Of these, 116 (74.83%) had been performed for pain from OA and 39 (25.16%) for RA. The RA group had a statistically significantly shorter interval to fusion than did those with OA (93 and 113 days, respectively; p = .025). The overall incidence of fusion for those with RA was 94% and for those with OA was 89%; however, this difference was neither clinically nor statistically significantly different (p = .36). The incidence of first MTP arthrodesis was high for both patients with OA and those with RA, and those with RA appeared to achieve fusion more rapidly.
authors.affiliation: Attending Physician, Orthopedic Foot and Ankle Center, Westerville, OH. Electronic address: ofacresearch@orthofootankle.com.
authors.forename: Christopher F
authors.initials: CF
authors.lastname: Hyer
authors.affiliation: Fellow, Orthopedic Foot and Ankle Center, Westerville, OH.
authors.forename: Shawn
authors.initials: S
authors.lastname: Morrow
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000601:surgery*; D001174:Arthrodesis; D005260:Female; D006801:Humans; D008297:Male; D008683:Metatarsophalangeal Joint / Q000601:surgery*; D008875:Middle Aged; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D012189:Retrospective Studies
keywords: fusion; internal fixation; metatarsal; osteoarthritis; phalanx; rheumatoid arthritis; surgery