CME OnDemand: 2022 AOFAS Annual Meeting-Polyvinyl Alcohol Hydrogel Hemiarthroplasty of First Metatarsophalangeal Joint Hallux Rigidus: Single Surgeon Five-Year Experience

Polyvinyl Alcohol Hydrogel Hemiarthroplasty of First Metatarsophalangeal Joint Hallux Rigidus: Single Surgeon Five-Year Experience

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Pdf Summary

This study investigates the outcomes of polyvinyl alcohol (PVA) hydrogel implant hemiarthroplasty for the treatment of hallux rigidus (HR) in a single surgeon's five-year experience. HR is a common arthritic condition of the foot, particularly in individuals aged >75 years. Traditionally, first metatarsophalangeal joint (MTPJ) arthrodesis has been considered the gold standard treatment for late-stage HR. However, PVA hydrogel implants have gained popularity as a joint-sparing technique due to their similar biomechanical properties to native cartilage, allowing for preservation of MTPJ motion. Previous studies have shown comparable pain relief and functional outcomes to arthrodesis, with excellent five-year survivorship. However, recent studies have reported variable failure rates for PVA hydrogel implants in HR. Therefore, the purpose of this study was to report the outcomes of 146 patients who underwent primary PVA hydrogel implant hemiarthroplasty for symptomatic late-stage HR. The results showed that the procedure resulted in significantly improved pain and hallux dorsiflexion at an average of 15 months postoperatively. The two-year survivorship was high at 86.3%, but eventual failure often required conversion to arthrodesis. The study concludes that future prospective studies should be conducted to refine the indications for PVA hydrogel implants and identify risk factors for failure.

Asset Subtitle

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

Keywords

PVA hydrogel

implant

hemiarthroplasty

hallux rigidus

arthritic condition

MTPJ arthrodesis

biomechanical properties

pain relief

five-year survivorship

failure rates