Abstract
As first metatarsophalangeal joint arthrodesis is generally considered to be a successful
procedure for the treatment of hallux rigidus, many surgeons question the usefulness
of total joint replacement. In an effort to elucidate the clinical evidence, we undertook
a systematic review of the literature comparing the functional outcomes of arthrodesis
and joint replacement in first metatarsophalangeal surgery. Using multiple search
engines and medical subject headings, 10 articles were eligible for inclusion: 5 featured
arthrodesis and 5 featured total joint replacement. The American Orthopaedic Foot
and Ankle Society–Hallux metatarsophalangeal-interphalangeal score was used in all
articles. The mean age at operation was 53 years for joint replacement patients and
55 for those undergoing joint arthrodesis. Most patients in all studies were female.
There was a significant increase from pre- to postoperative scores in both procedures.
The median postoperative score for joint replacement was 83/100 (range 74–95) and
82/100 (range 78–89) for arthrodesis. The median revision rate in joint replacements
was 7% (range 0%–10%) and 0% (range 0%–12%) for arthrodesis. This systematic review
reveals that arthrodesis achieves better functional outcomes than total joint replacement.
The operative techniques and prostheses for joint replacements are however still in
an early stage of development and advances still need to be achieved to produce a
more successful and anatomical prosthesis that could be functionally superior to an
arthrodesis.
Level of Clinical Evidence
Keywords
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Article info
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
Identification
Copyright
© 2010 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.
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- Brewster M. “Does total joint replacement or arthrodesis of the first metatarsophalangeal joint yield better functional results? A systematic review of the literature”The Journal of Foot and Ankle SurgeryVol. 50Issue 2
