title: Functional Outcomes Following First Metatarsophalangeal Arthrodesis.
abstract: BACKGROUND
  First metatarsophalangeal (MTP) joint arthrodesis is a common procedure for treatment of arthritis of the first MTP joint. The primary aim of this study was to evaluate the functional outcomes of a series of patients of multiple surgeons undergoing first MTP joint arthrodesis, emphasizing the functional gains with respect to daily activity that can be expected after this procedure.
  
  
  METHODS
  A retrospective review of 53 patients who underwent successful isolated first MTP joint arthrodesis with either a plate and screw or independent screw construct was performed at our institution over a 6-year period. Successful fusion was defined as no lucency at the first MTP joint and bridging of 2 or more cortices on the anteroposterior, lateral, and oblique radiographic views at final follow-up. Demographic information and radiographs were evaluated for all patients. Preoperative and postoperative Foot and Ankle Outcome Score (FAOS) and Short Form Health Status Survey (SF) 36/12 functional outcome scores, as well as responses from an activity- and footwear-specific questionnaire, were evaluated and compared between the 2 fixation methods. Fifty-three patients (56 feet) had radiographs showing successful fusions after being treated for advanced degenerative arthritis of the first MTP joint with arthrodesis. Average time to union was 5.4 months.
  
  
  RESULTS
  There was a significant reduction in difficulty in performing daily activities, with all subscales of the FAOS and the SF-12v2 significantly improving postoperatively (P < .05). The majority of patients stated that their foot looked and felt better and were satisfied with the procedure. Five patients experienced painful hardware, which required removal.
  
  
  CONCLUSIONS
  First MTP joint arthrodesis was successful in improving patient-reported outcomes, particularly the ability to perform daily activities. Most patients had little to no functional limitation and were satisfied with their outcome. The greatest functional improvements were seen in patients' ability to walk distances and perform low-impact sport activity.
  
  
  METHODS
  Level III, retrospective comparative study.
authors.affiliation: Hospital for Special Surgery, New York, NY, USA desandisb@hss.edu.
authors.forename: Bridget
authors.initials: B
authors.lastname: DeSandis
authors.affiliation: Mount Sinai St. Luke's and Mount Sinai West, New York, NY, USA.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Pino
authors.affiliation: Hospital for Special Surgery, New York, NY, USA.
authors.forename: David S
authors.initials: DS
authors.lastname: Levine
authors.affiliation: Hospital for Special Surgery, New York, NY, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Roberts
authors.affiliation: Hospital for Special Surgery, New York, NY, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Deland
authors.affiliation: Hospital for Special Surgery, New York, NY, USA.
authors.forename: Martin
authors.initials: M
authors.lastname: O'Malley
authors.affiliation: Hospital for Special Surgery, New York, NY, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Elliott
mesh_terms: D001860:Bone Plates; D001863:Bone Screws; D006801:Humans; D008683:Metatarsophalangeal Joint / Q000503:physiopathology / Q000601:surgery*; D010003:Osteoarthritis / Q000503:physiopathology / Q000601:surgery; D011859:Radiography / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: arthrodesis; functional outcomes; metatarsophalangeal