CME OnDemand: 2022 AOFAS Annual Meeting-First Metatarsophalangeal Arthrodesis Outcomes of Hallux Rigidus vs Hallux Valgus

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First metatarsophalangeal (MTP) arthrodesis, a surgical treatment for severe bunions and arthritis, has varying outcomes depending on the patient and surgical hardware used. A study aimed to compare the postoperative outcomes of patients with different conditions undergoing the procedure. The study included 210 patients who underwent the surgery between 2009 and 2021, with 136 patients meeting the inclusion criteria for follow-up. Radiographic measurements, complication rates, reoperation rates, and patient-reported outcome measures (PROMs) were collected and analyzed. <br /><br />The results showed that the improvement in radiographic parameters was significantly larger in patients with bunions compared to those with arthritis. PROMs showed a trend towards improvement at the 3-year mark, with significant improvements in pain, quality of life, and functional activities in the arthritis group. Overall, complication and reoperation rates did not differ between patient groups, although the nonunion rate was highest in the bunion group. <br /><br />The study suggests that specific forefoot pathology does not significantly influence postoperative outcomes other than radiographic parameters. It also highlights the need for a future prospective study to gather more data and draw further conclusions regarding the impact of diagnosis on the success of first MTP arthrodesis. <br /><br />In conclusion, while there are differences in radiographic outcomes and PROMs between patients with bunions and arthritis undergoing first MTP arthrodesis, there are no significant differences in complication or reoperation rates. Further research is needed to gain a better understanding of the role of specific forefoot pathology in the outcomes of this surgical procedure.

Asset Subtitle

Warren J. Roth, Caroline P. Hoch, Christopher E. Gross, MD, Daniel J. Scott, MD, MBA

Keywords

First metatarsophalangeal arthrodesis

severe bunions

arthritis

surgical treatment

patient outcomes

radiographic measurements

complication rates

reoperation rates

patient-reported outcome measures

PROMs