Short-Term Outcomes of Arthroscopic Treatment of Freiberg Disease.

IF 0.5 4区 医学 Q4 ORTHOPEDICS Journal of the American Podiatric Medical Association Pub Date : 2024-05-01 DOI:10.7547/22-025
Jong-Kil Kim, Do-Yeon Kim, Jong-Sung Oh, Dong-Ill Ko, Kwang-Bok Lee
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Abstract

Background: Surgical treatment for Freiberg disease (also known as avascular necrosis of the metatarsal head) has not been completely defined. This retrospective study evaluated short-term outcomes after arthroscopic treatment of Freiberg disease.

Methods: From 2015 to 2019, 13 patients (15 feet) diagnosed as having Freiberg disease were enrolled for arthroscopic surgery. Feet were divided based on the Smillie classification system (two with stage I, eight with stage II, three with stage III, one with stage IV, and one with stage V). Arthroscopic interventions, including synovectomy, debridement, chondroplasty, microfracture, and loose body removal, were performed without considering the Smillie classification stage. Radiologic outcomes were evaluated by radiography (preoperatively and 3, 6, and 12 months postoperatively) and magnetic resonance imaging (preoperatively and 12 months postoperatively). Clinical outcomes were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) lesser metatarsophalangeal (MTP)-interphalangeal score and the visual analog scale (VAS) score. The MTP joint range of motion was measured using a goniometer preoperatively and postoperatively.

Results: Radiologic studies showed no evidence of osteonecrosis progression in postoperative 12-month radiographs of any patients. Postoperative 12-month magnetic resonance images showed reduction of bone marrow edema, irregularity of subchondral bone, and cartilage defects in all patients. Significant improvements in AOFAS and VAS scores occurred at all postoperative time points compared with preoperative scores (P = .001). The MTP joint range of motion also showed improvement at last follow-up (P = .001).

Conclusions: Arthroscopic surgery for Freiberg disease showed excellent clinical outcomes, MTP joint range of motion, and short-term outcomes regardless of stage (Smillie classification) in radiologic evaluation.

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关节镜治疗弗赖贝格病的短期疗效。
背景:弗赖贝格病(又称跖骨头血管性坏死)的手术治疗方法尚未完全确定。这项回顾性研究评估了关节镜治疗弗赖贝格病后的短期疗效:2015年至2019年,13名被诊断为弗莱贝格病的患者(15只脚)接受了关节镜手术。根据Smillie分类系统对足部进行了划分(2例I期,8例II期,3例III期,1例IV期,1例V期)。关节镜手术包括滑膜切除术、清创术、软骨成形术、微骨折术和松动体切除术,均在不考虑斯米利分类分期的情况下进行。放射学结果通过放射摄影(术前、术后 3、6 和 12 个月)和磁共振成像(术前和术后 12 个月)进行评估。临床效果采用美国骨科足踝协会(AOFAS)跖趾关节(MTP)-指间关节评分和视觉模拟量表(VAS)评分进行评估。术前和术后使用动态关节角度计测量 MTP 关节的活动范围:结果:放射学研究显示,所有患者术后12个月的X光片均未显示骨坏死进展。术后12个月的磁共振图像显示,所有患者的骨髓水肿、软骨下骨不规则和软骨缺损均有所减轻。与术前相比,术后所有时间点的 AOFAS 和 VAS 评分均有显著改善(P = .001)。最后一次随访时,MTP关节活动范围也有所改善(P = .001):结论:无论放射学评估分期(Smillie分类)如何,关节镜手术治疗弗赖贝格氏病在临床疗效、MTP关节活动范围和短期疗效方面均表现出色。
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来源期刊
CiteScore
1.10
自引率
0.00%
发文量
128
审稿时长
6-12 weeks
期刊介绍: The Journal of the American Podiatric Medical Association, the official journal of the Association, is the oldest and most frequently cited peer-reviewed journal in the profession of foot and ankle medicine. Founded in 1907 and appearing 6 times per year, it publishes research studies, case reports, literature reviews, special communications, clinical correspondence, letters to the editor, book reviews, and various other types of submissions. The Journal is included in major indexing and abstracting services for biomedical literature.
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