Return to Sport after First Metatarsophalangeal Arthrodesis in Elite Athletes.

Abstract

Introduction: Arthrodesis of the first metatarsophalangeal joint (MTPJ) is a reliable procedure in alleviating pain and restoring function. However, there is limited published literature of the outcomes of this procedure and the ability to return to sport in elite athletes. This study aims to assess the outcomes of first MTPJ arthrodesis in the elite athlete population and their ability to return to professional sport.

Methods: A single-center prospective case series of elite athletes undergoing first MTPJ arthrodesis between 2004 and 2016 was conducted. Patients were assessed a minimum of 2, 6, 12 weeks and 1-year post-operation and at final follow-up. Clinical outcomes were evaluated using the Foot and Ankle Outcome Score (FAOS) and Visual Analogue Scale (VAS) scores and assessing satisfaction.

Results: 16 elite athletes with a mean age of 27 years (range 19-32, 81%) and mean follow-up of 81 months (range 60-121 months) were included. At 1-year post-operation, 12 (75%) athletes returned to their original level of sport. Of the 4 unable to return, two soccer players dropped a division, an ATP tennis player never regained his original ranking, and a badminton player was unable to return to the same level of competition. Mean VAS scores improved from pre-operation to final follow-up (5.6 to 0.4, p < 0.001). All FAOS subscores showed significant improvement from pre-operation to final follow-up (all p < 0.05). All (100%) athletes were either very satisfied or satisfied at final follow-up.

Conclusion: To our knowledge this is the first study investigating return to elite level sport post first MTPJ arthrodesis. Our results confirm that a significant majority will return to their elite level of sport post operatively. Improved clinical outcomes and pain reduction was achieved in all patients.

Level of evidence: IV LEVEL OF EVIDENCE: V.