Presentation on theme: "27th Annual AOFAS Summer Meeting July 14, 2011. Alejandro E. Pino, MD Elizabeth Young, BS Lucas J. Bader, MD Chloe Cheng, BS Andrew J. Elliott, MD 1 Matthew."— Presentation transcript:
27th Annual AOFAS Summer Meeting July 14, 2011
Alejandro E. Pino, MD Elizabeth Young, BS Lucas J. Bader, MD Chloe Cheng, BS Andrew J. Elliott, MD 1 Matthew M. Roberts, MD David S. Levine, MD Jonathan T. Deland, MD 2 Martin OMalley, MD 1)Financial relationship with Bacterin 2)Financial relationship with Zimmer, Arthrex and Tornier
Introduction First Metatarsophalangeal Joint (MTPJ) Arthrodesis offers reliable pain relief Many accepted techniques Stigma due to perceived functional limitation
Introduction Good functional outcomes described One technique Single surgeon Homogeneous patient population
Our Study Review functional outcomes after first MTPJ arthrodesis Multiple surgeons Different fixation techniques Heterogeneous population
Hypothesis Arthrodesis for the treatment of severe degeneration of the first MTPJ yields good functional outcomes regardless of fixation technique. Principles of arthrodesis upheld
Methods HSS Dept of Foot/Ankle Surgery patient database CPT code Five different surgeons
Methods Pre/Postoperative FAOS, SF-12/36, activity/shoe wear specific questionnaire Brodsky et al FAI 2005 Radiographic evaluation
Methods Subgroup analysis Arthrodesis technique Cross screws versus Plate/lag screw Previous surgery Concomitant procedure
Discussion Union rate Plate/screw vs Cross screw Satisfaction rate Shoe wear limitations
References 1. Baumhauer, JF; Nawoczenski, DA; DiGiovanni, BF; Wilding, GE: Reliability and validity of the American Orthopaedic Foot and Ankle Society Clinical Rating Scale: a pilot study for the hallux and lesser toes. Foot Ankle Int. 27: , Beertema, W; Draijer, WF; van Os, JJ; Pilot, P: A retrospective analysis of surgical treatment in patients with symptomatic hallux rigidus: long-term follow-up. J. Foot Ankle Surg. 45: , Bennett, GL; Sabetta, J: First metatarsalphalangeal joint arthrodesis: evaluation of plate and screw fixation. Foot Ankle Int. 30: , Bennett, GL; Kay, DB; Sabatta, J: First metatarsophalangeal joint arthrodesis: an evaluation of hardware failure. Foot Ankle Int. 26: , Brodsky, JW; Passmore, RN; Pollo, FE; Shabat, S: Functional outcome of arthrodesis of the first metatarsophalangeal joint using parallel screw fixation. Foot Ankle Int. 26: , Button, G; Pinney, S: A meta-analysis of outcome rating scales in foot and ankle surgery: is there a valid, reliable, and responsive system? Foot Ankle Int. 25: , Chen, L; Lyman, S; Do, H; Adam, S; Young, E; Deland, J; Ellis, S: Validation of the Foot and Ankle Outcome Score for Hallux Valgus. Hospital for Special Surgery Fellow Presentation, Coughlin, MJ; Shurnas, PS: Hallux rigidus. J. Bone Joint Surg. Am. 86-A Suppl 1: , Coughlin, MJ; Shurnas, PS: Hallux rigidus. Grading and long-term results of operative treatment. J. Bone Joint Surg. Am. 85-A: , 2003.
References 10. DeFrino, PF; Brodsky, JW; Pollo, FE; Crenshaw, SJ; Beischer, AD: First metatarsophalangeal arthrodesis: a clinical, pedobarographic and gait analysis study. Foot Ankle Int. 23: , Fuhrmann, RA: First metatarsophalangeal arthrodesis for hallux rigidus. Foot Ankle Clin. 16:1-12, Goucher, NR; Coughlin, MJ: Hallux metatarsophalangeal joint arthrodesis using dome-shaped reamers and dorsal plate fixation: a prospective study. Foot Ankle Int. 27: , Hope, M; Savva, N; Whitehouse, S; Elliot, R; Saxby, TS: Is it necessary to re-fuse a non-union of a Hallux metatarsophalangeal joint arthrodesis? Foot Ankle Int. 31: , Kumar, S; Pradhan, R; Rosenfeld, PF: First metatarsophalangeal arthrodesis using a dorsal plate and a compression screw. Foot Ankle Int. 31: , Poggio, D; de Retana, PF; Borda, D; Hortua, P; Asuncion, J; Rios, J: Analysis of the clinical score progressions during the first year after first MTPJ fusion. Foot Ankle Int. 31: , Raikin, SM; Ahmad, J; Pour, AE; Abidi, N: Comparison of arthrodesis and metallic hemiarthroplasty of the hallux metatarsophalangeal joint. J. Bone Joint Surg. Am. 89: , User's Manual for the SF-36v2 Health Survey, Second Edition, Chapter 3: van Doeselaar, DJ; Heesterbeek, PJ; Louwerens, JW; Swierstra, BA: Foot function after fusion of the first metatarsophalangeal joint. Foot Ankle Int. 31: , Womack, JW; Ishikawa, SN: First metatarsophalangeal arthrodesis. Foot Ankle Clin. 14:43-50, 2009.