First metatarsophalangeal joint arthrodesis - Do joint configuration and preparation technique matter?
BACKGROUND
The purpose of this study was to investigate the influence of joint configuration and preparation on first metatarsophalangeal (MTPJ) union rates.


METHODS
We performed a retrospective analysis of first MTPJ arthrodeses undertaken in our institution. Clinical notes, radiographs and postal questionnaires were used to determine outcome.


RESULTS
Two hundred first MTPJ arthrodeses (172 patients) were included in the analysis (34 male: 138 female; mean age 62 yr). The overall union rate was 93.5%. Union was achieved in 109/118 MTPJs (92.4%) prepared in the flat-on-flat configuration and in 78/82 (95%) prepared in the ball-and-socket configuration (p=0.438). Higher union rates favoured low-velocity joint preparation [using rongeur only 21/21 (100%), rongeur and burr 26/27 (96.3%) and conical reamer 31/34 (91.2%)] but this did not reach statistical significance (p=0.317). There was a 95% satisfaction rate with surgery but male patients were less satisfied (p=0.031).


CONCLUSIONS
Union rates were not influenced by joint configuration or preparation techniques.
Leicester Orthopaedics, University Hospitals of Leicester, Leicester General Hospital, LE5 4PW, UK. Electronic address: m.deven@gmail.com.
D
D
Mahadevan
Leicester Orthopaedics, University Hospitals of Leicester, Leicester General Hospital, LE5 4PW, UK.
M T
MT
Korim
Leicester Orthopaedics, University Hospitals of Leicester, Leicester General Hospital, LE5 4PW, UK.
A
A
Ghosh
Leicester Orthopaedics, University Hospitals of Leicester, Leicester General Hospital, LE5 4PW, UK.
P E
PE
Allen
Leicester Orthopaedics, University Hospitals of Leicester, Leicester General Hospital, LE5 4PW, UK.
M
M
Bhatia
Leicester Orthopaedics, University Hospitals of Leicester, Leicester General Hospital, LE5 4PW, UK.
J
J
Mangwani
D000368:Aged; D001168:Arthritis / Q000601:surgery*; D001174:Arthrodesis / Q000379:methods*; D005260:Female; D006214:Hallux / Q000601:surgery; D020859:Hallux Rigidus / Q000601:surgery*; D006215:Hallux Valgus / Q000601:surgery*; D006801:Humans; D008297:Male; D008683:Metatarsophalangeal Joint / Q000601:surgery; D008875:Middle Aged; D012189:Retrospective Studies
Configuration; Metatarsophalangeal arthrodesis; Preparation; Satisfaction; Technique; Union