Operative Treatment for Osteoarthritis of the First Metatarsophalangeal Joint: Arthrodesis Versus Hemiarthroplasty.
Controversy remains whether hemiarthroplasty or arthrodesis results in better postoperative outcomes for patients who request surgery for advanced osteoarthritis of the first metatarsophalangeal joint. Therefore, we tested the primary null hypothesis that the 2 treatment groups would not differ in the postoperative American Orthopaedic Foot and Ankle Society hallux metatarsophalangeal interphalangeal scale scores after a follow-up period of ≥1 year. Secondary analyses addressed the satisfaction rates, percentage of patients who would recommend the procedure, and unplanned repeat operation rates. A total of 58 primary arthrodeses and 36 hemiarthroplasties performed from January 2005 to December 2010 were evaluated at ≥1 year postoperatively. At a mean average of 4 (range 1 to 7) years after surgery, the mean American Orthopaedic Foot and Ankle Society hallux metatarsophalangeal interphalangeal scale score was 77.5 ± 18.5 in the arthrodesis group and 77.8 ± 12.0 in the arthroplasty group (p = .93). The number of repeat operations did not differ between these 2 groups, and patients treated with hemiarthroplasty reported greater mean satisfaction (p = .04). These results showed that the symptom intensity and magnitude of disability were similar at ≥1 year after arthrodesis or hemiarthroplasty for osteoarthritis of the first metatarsophalangeal joint, although the patients were subjectively more pleased with the results after hemiarthroplasty.
Resident, Orthopaedic Surgery, Groene Hart Ziekenhuis, Gouda, The Netherlands.
Timothy
T
Voskuijl
Orthopaedic Surgeon, Groene Hart Ziekenhuis, Gouda, The Netherlands. Electronic address: ron.onstenk@ghz.nl.
Ron
R
Onstenk
D000368:Aged; D001174:Arthrodesis; D005260:Female; D006214:Hallux / Q000601:surgery*; D020859:Hallux Rigidus / Q000601:surgery*; D062785:Hemiarthroplasty; D006801:Humans; D008297:Male; D008683:Metatarsophalangeal Joint / Q000601:surgery*; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery*; D017060:Patient Satisfaction
BioPro(®); arthritis; arthroplasty; fusion; implant; surgery