Bone-Block Arthrodesis Procedure in Failures of First Metatarsophalangeal Joint Replacement

Category: Midfoot/Forefoot Introduction/Purpose: The treatment of the failure of the first metatarsophalangeal joint (MTP1) prosthesis can be complex. There is no consensus regarding treatments options. The main issue is the available bone stock.The aim of the study was to report on clinical and rad...

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Main Authors: Camilla Maccario MD, Miriam Grassi MD, Federico G. Usuelli MD, Luigi Manzi MD
Format: Article
Language:English
Published: SAGE Publishing 2016-08-01
Series:Foot & Ankle Orthopaedics
Online Access:https://doi.org/10.1177/2473011416S00140
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author Camilla Maccario MD
Miriam Grassi MD
Federico G. Usuelli MD
Luigi Manzi MD
author_facet Camilla Maccario MD
Miriam Grassi MD
Federico G. Usuelli MD
Luigi Manzi MD
author_sort Camilla Maccario MD
collection DOAJ
description Category: Midfoot/Forefoot Introduction/Purpose: The treatment of the failure of the first metatarsophalangeal joint (MTP1) prosthesis can be complex. There is no consensus regarding treatments options. The main issue is the available bone stock.The aim of the study was to report on clinical and radiographic results for MTP1 arthrodesis with autologous bone graft (bone-block fusion) as a revision procedure of a previous MTP1 implant failure. Methods: We enrolled 12 patients who underwent MTP1 prosthesis failures and retrospectively collected data. All the patient underwent removal of the prosthetic implant and simultaneous MTp1 arthrodesis with autologous bone graft, harvested from the ipsilateral calcaneus (minimum follow-up of 24 months). The minimum time period elapsed between the surgical procedure of prosthetic implant and the revision surgery has been 18 months. Patients were evaluated preoperatively with a weight-bearing radiograph of the foot and CT-scan and at 24 months after surgery with Foot Ankle Disability Index (FADI). Results: The reasons for implant-failures were: 8 mobilization and 4 malalignment. The average defect filled with bone-block was 12.2 mm. The fusion was performed with a plate and locking-screws. We had 3 cases of asymptomatic nonunion at the falangeal side of the fusion, none on the other side. Mean average rate of consolidation in other patients was 10 weeks. All patients returned to common activities’ of daily living. Average FADI was foun1d to be 84.6 at final follow-up. Conclusion: The management of this pathology is still controversial. Bone-block MTP1 arthrodesis The main limitation of the study is the small sample. seems to be a viable option.
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spelling doaj.art-5b3796a91b6343c2a9c3cf2bdd7068c92022-12-21T18:42:43ZengSAGE PublishingFoot & Ankle Orthopaedics2473-01142016-08-01110.1177/2473011416S00140Bone-Block Arthrodesis Procedure in Failures of First Metatarsophalangeal Joint ReplacementCamilla Maccario MDMiriam Grassi MDFederico G. Usuelli MDLuigi Manzi MDCategory: Midfoot/Forefoot Introduction/Purpose: The treatment of the failure of the first metatarsophalangeal joint (MTP1) prosthesis can be complex. There is no consensus regarding treatments options. The main issue is the available bone stock.The aim of the study was to report on clinical and radiographic results for MTP1 arthrodesis with autologous bone graft (bone-block fusion) as a revision procedure of a previous MTP1 implant failure. Methods: We enrolled 12 patients who underwent MTP1 prosthesis failures and retrospectively collected data. All the patient underwent removal of the prosthetic implant and simultaneous MTp1 arthrodesis with autologous bone graft, harvested from the ipsilateral calcaneus (minimum follow-up of 24 months). The minimum time period elapsed between the surgical procedure of prosthetic implant and the revision surgery has been 18 months. Patients were evaluated preoperatively with a weight-bearing radiograph of the foot and CT-scan and at 24 months after surgery with Foot Ankle Disability Index (FADI). Results: The reasons for implant-failures were: 8 mobilization and 4 malalignment. The average defect filled with bone-block was 12.2 mm. The fusion was performed with a plate and locking-screws. We had 3 cases of asymptomatic nonunion at the falangeal side of the fusion, none on the other side. Mean average rate of consolidation in other patients was 10 weeks. All patients returned to common activities’ of daily living. Average FADI was foun1d to be 84.6 at final follow-up. Conclusion: The management of this pathology is still controversial. Bone-block MTP1 arthrodesis The main limitation of the study is the small sample. seems to be a viable option.https://doi.org/10.1177/2473011416S00140
spellingShingle Camilla Maccario MD
Miriam Grassi MD
Federico G. Usuelli MD
Luigi Manzi MD
Bone-Block Arthrodesis Procedure in Failures of First Metatarsophalangeal Joint Replacement
Foot & Ankle Orthopaedics
title Bone-Block Arthrodesis Procedure in Failures of First Metatarsophalangeal Joint Replacement
title_full Bone-Block Arthrodesis Procedure in Failures of First Metatarsophalangeal Joint Replacement
title_fullStr Bone-Block Arthrodesis Procedure in Failures of First Metatarsophalangeal Joint Replacement
title_full_unstemmed Bone-Block Arthrodesis Procedure in Failures of First Metatarsophalangeal Joint Replacement
title_short Bone-Block Arthrodesis Procedure in Failures of First Metatarsophalangeal Joint Replacement
title_sort bone block arthrodesis procedure in failures of first metatarsophalangeal joint replacement
url https://doi.org/10.1177/2473011416S00140
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AT federicogusuellimd boneblockarthrodesisprocedureinfailuresoffirstmetatarsophalangealjointreplacement
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