CME OnDemand: 2022 AOFAS Annual Meeting-Early Results with the Use of Synthetic Cartilage Implant Augmented with 3D Printed Baseplate to Prevent Implant Subsidence for Treatment of Hallux Rigidus

Early Results with the Use of Synthetic Cartilage Implant Augmented with 3D Printed Baseplate to Prevent Implant Subsidence for Treatment of Hallux Rigidus

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This study aimed to evaluate the outcomes of patients who underwent synthetic cartilage implant (SCI) resurfacing augmented with a 3D-printed baseplate for the treatment of Hallux rigidus (HR). HR is a common arthritic disease that causes pain and stiffness in the first metatarsophalangeal joint. SCI resurfacing has gained popularity as a treatment option as it has similar properties to native cartilage and preserves joint motion. However, implant subsidence has been reported, leading to treatment failure and revision surgery.<br /><br />In this study, electronic health records were reviewed for patients who underwent SCI resurfacing with a custom 3D-printed baseplate by a single surgeon. The 3D-printed baseplate was inserted proximally into the metatarsal head underneath the SCI. A total of 21 patients were included in the study, with a mean follow-up of 9.8 months. Significant improvements in pain scores were observed, and the SCI augmented with the 3D-printed baseplate had a survivorship of 90%, with only two patients requiring revision surgery for implant subsidence and sesamoidal arthritis.<br /><br />Additionally, two patients underwent reoperation for staple removal and infection. On x-ray imaging, the first metatarsophalangeal joint space was maintained for the majority of patients, with only two patients showing implant subsidence. Overall, the use of 3D-printed baseplates in conjunction with SCI resurfacing resulted in significant pain improvements and prevented implant subsidence.<br /><br />The authors suggest that future prospective studies should be conducted to further investigate the outcomes of this technique in preventing SCI subsidence in the treatment of HR.

Asset Subtitle

Naji S. Madi, MD, Amanda N. Fletcher, MD, MS, Aman Chopra, BA, Selene G. Parekh, MD, MBA

Keywords

synthetic cartilage implant

3D-printed baseplate

Hallux rigidus

arthritic disease

joint motion

implant subsidence

revision surgery

electronic health records

pain scores

sesamoidal arthritis