edoc

Mid-term functional outcome of a total arthroplasty of the first metatarsophalangeal joint

Nüesch, Corina and Mündermann, Annegret and Horisberger, Monika. (2017) Mid-term functional outcome of a total arthroplasty of the first metatarsophalangeal joint. Clinical biomechanics, 41. pp. 9-13.

[img] PDF - Accepted Version
Available under License CC BY-NC-ND (Attribution-NonCommercial-NoDerivatives).

931Kb

Official URL: http://edoc.unibas.ch/58569/

Downloads: Statistics Overview

Abstract

Arthroplasty of the first metatarsophalangeal joint is an alternative treatment option for end-stage hallux rigidus to the current gold standard of arthrodesis. The aim of this study was to investigate the mid-term functional outcome of an anatomically shaped prosthesis for the first metatarsophalangeal joint using pedobarography.; Ten patients (12 affected feet; age at surgery: 62.1 (SD: 7.2) years) were investigated preoperatively and 52 (SD: 3) months postoperatively using pedobarography (EMED, novel GmbH, Munich, Germany). Two patients were excluded at follow-up because their prosthesis was converted to an arthrodesis. Peak force and plantar pressure under the five metatarsal heads and the hallux were analyzed and correlated with the clinical outcome (pain, American Orthopaedic Foot and Ankle Society forefoot score and radiographic maximum first metatarsophalangeal dorsiflexion). Differences between pre- and postoperative data were analyzed using paired t-tests (alpha=0.05).; Postoperatively, forefoot peak forces under the fourth (+40.9%; P=0.018) and fifth metatarsal (+54.9%; P=0.037) and plantar pressures under the fifth metatarsal (+38.7%; P=0.027) increased significantly, while peak plantar pressures and forces under the hindfoot, medial forefoot and hallux did not change. While maximum passive dorsiflexion was not significantly greater at the 4-year follow-up compared to preoperatively, overall greater passive dorsiflexion was associated with higher first metatarsal peak pressure.; Despite of patients reporting less pain, the functional results indicate an altered and potentially non-physiological postoperative gait pattern with a lateralization of the load during walking, especially in patients with limited passive dorsiflexion.
Faculties and Departments:03 Faculty of Medicine > Bereich Operative Fächer (Klinik) > Bewegungsapparat und Integument > Traumatologie / Orthopädie (Jakob)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Operative Fächer (Klinik) > Bewegungsapparat und Integument > Traumatologie / Orthopädie (Jakob)
03 Faculty of Medicine > Departement Biomedical Engineering > Biomechanics and Biomaterials
UniBasel Contributors:Mündermann, Annegret and Nüesch, Corina and Horisberger, Monika
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Elsevier
ISSN:0268-0033
e-ISSN:1879-1271
Note:Publication type according to Uni Basel Research Database: Journal article
Language:English
Identification Number:
Last Modified:05 Feb 2018 10:34
Deposited On:23 Jan 2018 14:14

Repository Staff Only: item control page