CME OnDemand: 2022 AOFAS Annual Meeting-Results of an Interim Analysis of a Prospective Multicenter Study Assessing Radiographic and Patient Outcomes Following Triplanar Tarsometatarsal Arthrodesis with Early Weightbearing

Results of an Interim Analysis of a Prospective Multicenter Study Assessing Radiographic and Patient Outcomes Following Triplanar Tarsometatarsal Arthrodesis with Early Weightbearing

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This document summarizes the interim results of a 5-year study evaluating the use of a specific instrumentation set for the treatment of hallux valgus (HV), or bunions. The study aims to assess the radiographic recurrence, anatomical alignment correction, outcomes of early weightbearing, and quality of life and pain scores in patients undergoing HV treatment.<br /><br />The study includes 159 patients with a mean follow-up of 22.2 months. The surgical method involves an instrument-assisted correction system with triplanar realignment arthrodesis of the first tarsometatarsal joint. The results show significant improvements in radiographic measures, including hallux valgus angle (HVA), intermetatarsal angle (IMA), and tarsal metatarsophalangeal (TSP) angle, at various post-operative time points.<br /><br />Patient-reported outcomes demonstrate significant improvements in pain, functional ability, and quality of life at 6, 12, and 24 months post-surgery. The average return to weight-bearing in a CAM boot was 8.3 days, and return to work and athletic footwear took 29.2 and 46.2 days, respectively.<br /><br />Hardware breakage occurred in 2.9% of patients, but none required reoperation, and all maintained radiographic correction. Hardware removal was performed in 6.9% of patients, mainly due to pain or non-union, resulting in symptom resolution in the majority of cases.<br /><br />The study reports a recurrence rate of radiographic correction loss in 1.4% of patients. However, the overall radiographic correction was maintained in 98.6% of patients.<br /><br />Limitations of the study include a lack of specific quantification for early protected weightbearing and the selection of HV deformities within certain parameters. The study also involved experienced users of the instrumentation system.<br /><br />In conclusion, the study demonstrates positive outcomes in terms of anatomical alignment correction, pain reduction, and functional improvement in patients undergoing HV treatment with the specific instrumentation set. The majority of patients achieved union, and although hardware complications occurred in some cases, post-operative correction was maintained.

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Robert D. Santrock, MD, Daniel C. Farber, MD, Abdi Raissi, MD, Avneesh Chhabra, Jennifer Koay, Paul Dayton, MS, DPM, Daniel J. Hatch, FACFAS, Jody McAleer, DPM, FACFAS, Dane K. Wukich, MD, Robert P. Taylor, Deidre Kile

Keywords

hallux valgus

bunions

instrumentation set

radiographic recurrence

anatomical alignment correction

early weightbearing

quality of life

pain scores

surgical method

tarsometatarsal joint