CME OnDemand: 2022 AOFAS Annual Meeting-Revision Surgery after Failed Index Synthetic Cartilage Implant Resurfacing for Hallux Rigidus: Single Surgeon Five-Year Experience

Revision Surgery after Failed Index Synthetic Cartilage Implant Resurfacing for Hallux Rigidus: Single Surgeon Five-Year Experience

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Pdf Summary

Hallux rigidus (HR) is a common arthritic disease that causes pain and stiffness in the first metatarsophalangeal joint (MTPJ). The gold standard treatment for HR is MTPJ arthrodesis, but synthetic cartilage implant (SCI) resurfacing offers a pain-free option that preserves joint motion. However, there have been variable failure rates reported with SCI resurfacing, often due to implant subsidence. This study aimed to identify the failure rate of SCI resurfacing by a single surgeon and compare the outcomes of patients who underwent revision with either SCI replacement or MTPJ arthrodesis.<br /><br />The electronic health records of symptomatic HR patients treated with SCI were analyzed. Patient demographics, BMI, medical comorbidities, ASA physical status, past surgical history, and follow-up periods were recorded. Preoperative and postoperative range of motion, pain scores, hallux valgus angles, and x-ray imaging were compared. A subgroup analysis was performed on patients who underwent revision, with descriptive and univariate statistics used for data analysis.<br /><br />The study found an 8.2% revision rate for index SCI performed by a single surgeon. The total revision cohort showed significant improvement in pain scores, but the MTPJ arthrodesis cohort had greater improvement compared to the SCI revision cohort. There were no significant differences observed in range of motion and hallux valgus angle between the two groups.<br /><br />The study had limitations such as a small cohort size and the absence of patient satisfaction or reported outcome measurements. It concluded that MTPJ arthrodesis was more effective at reducing pain after the failure of index SCI resurfacing procedures. Prospective studies should be conducted in the future.

Asset Subtitle

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

Keywords

Hallux rigidus

arthritic disease

pain

stiffness

metatarsophalangeal joint

MTPJ arthrodesis

synthetic cartilage implant

SCI resurfacing

implant subsidence

failure rate