Ten-Year Minimum Follow-up Study of First Metatarsophalangeal Joint Fusion in Young vs Old Patients

Sage Publications 2024-03-01

BACKGROUND Painful degenerative joint disease (DJD) of the first metatarsophalangeal joint (MTP I), or hallux rigidus, mainly occurs in later stages of life. For end-stage hallux rigidus, MTP I arthrodesis is considered the gold standard. As young and active patients are affected considerably less frequently, it currently remains unclear, whether they benefit to the same extent. We hypothesized that MTP I arthrodesis in younger patients would lead to an inferior outcome with decreased rates of overall with lower rates of patient postoperative pain and function compared to an older cohort. METHODS All patients aged <50 y ears who underwent MTP I arthrodesis at our institution between 1995 and 2012 were included in this study. This group was then matched and compared with a group of patients aged >60 years. Minimum follow-up was 10 years. Outcome measures were Tegner activity score (TAS), a "Virtual Tegner activity score" (VTAS), the visual analog scale (VAS), and the Foot Function index (FFI). RESULTS Sixty-one MTP I fusions (n = 28 young, n = 33 old) in 46 patients were included in our study at an average of 14 years after surgery. Younger patients experienced significantly more pain relief as reflected by changes in VAS and FFI Pain subscale scores. No difference in functional outcomes was found with change in the FFI function subscale or in the ability to have desired functional outcomes using the ratio of TAS to VTAS. Revision rate did not differ between the two groups apart from hardware removal, which was significantly more likely in the younger group. CONCLUSION In patients below the age of 50 years with end-stage DJD of the first metatarsal joint, MTP I arthrodesis not only yielded highly satisfactory postoperative results at least equal outcome compared to an older cohort of patients aged >60 years at an average 14 years' follow-up. Based on these findings, we consider first metatarsal joint fusion even for young patients is a valid option to treat end-stage

Balgrist University Hospital, Swiss Spinal Cord Injury Center; 610 Medicine & health; Journal Article; PeerReviewed; info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion

Open access content. Open access content
info:eu-repo/semantics/openAccess
Creative Commons: Attribution 4.0 International (CC BY 4.0)
http://creativecommons.org/licenses/by/4.0
info:eu-repo/semantics/openAccess

application/pdf
info:doi/10.5167/uzh-254739
English
English

CHUZH oai:www.zora.uzh.ch:254739
https://www.zora.uzh.ch/id/eprint/254739/1/2023_Scheurer_Ten_Year_Minimum_Follow_up_Study_of_First_Metatarsophalangeal_Joint_Fusion_in_Young_vs_Old_Patients_FAI.pdf
info:doi/10.5167/uzh-254739
info:doi/10.1177/10711007231205567
info:pmid/38158798
urn:issn:1071-1007
1443057167

HAUPTBIBLIOTHEK UNIV OF ZURICH
From OAIster®, provided by the OCLC Cooperative.

edsoai.on1443057167