Chase Gauthier , Thomas Lewis , John O’Keefe , Yianni Bakaes , Vikram Vignaraja , J. Benjamin Jackson III , Samuel Franklin , Jonathan Kaplan , Robbie Ray , Tyler Gonzalez
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This study aims to examine the effectiveness of MIDC with first MTP arthroscopy in patients with HR with a minimum 1-year follow-up.</p></div><div><h3>Methods</h3><p>This was a multicenter retrospective review for adult patients with Coughlin and Shurnass Grade 0–3 who were treated with MIDC and first MTP arthroscopy between 3/1/2020 and 8/1/2022, with at least one year of follow-up data. Demographic information, first MTP range of motion (ROM), visual analog scale (VAS), Manchester-Oxford Foot Questionnaire (MOXFQ), and EQ-5D-5 L scores were collected. Continuous data was expressed as a mean and standard deviation, categorical data was expressed as a percentage. Wilcoxon Rank Sum test was used to compare continuous variables. All P < 0.05 was considered significant.</p></div><div><h3>Results</h3><p>A total of 31 patients were included in the study. Average follow-up time was 16.5 months (range: 12 to 26.2). There was 1 (3.2%) undersurface EHL tendon tear, 2 (6.5%) conversions to an MTP fusion, and 1 (3.2%) revision cheilectomy and capsular release for MTP joint contracture. There was a significant improvement in patient’s ROM in dorsiflexion (50 vs 89.6 degrees, P = 0.002), postoperative VAS pain scores (6.4 vs 2.1, P < 0.001), MOXFQ pain scores (58.1 vs 30.7, P = 0.001), MOXFQ Walking/Standing scores (56.6 vs 20.6, P = 0.001), MOXFQ Social Interaction scores (47.3 vs 19.36, P = 0.002), and MOXFQ Index scores (54.7 vs 22.4, P < 0.001).</p></div><div><h3>Conclusion</h3><p>We found that MIDC with first MTP arthroscopy was effective at improving patient-reported outcomes at one year with low complication and revision rates. 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引用次数: 0
摘要
微创背螯切除术(MIDC)已成为治疗Hallux Rigidus(HR)的开放式方法的流行替代方法。为了减少与MIDC方法相关的一些并发症,除了可以进行第一跖趾关节(MTP)关节镜检查外,还可以解决与Hallux Rigidus相关的关节内病理问题。本研究旨在对至少随访1年的Harrux Rigidus患者进行MIDC与第一跖趾关节镜检查的有效性研究。这是一项多中心回顾性研究,研究对象是在2020年1月3日至2022年1月8日期间接受MIDC和首次MTP关节镜治疗的Coughlin和Shurnass 0-3级成人患者,随访数据至少一年。研究人员收集了患者的人口统计学信息、首次 MTP 活动范围 (ROM)、视觉模拟量表 (VAS)、曼彻斯特-牛津足部问卷 (MOXFQ) 和 EQ-5D-5L 评分。连续数据以均值和标准差表示,分类数据以百分比表示。连续变量的比较采用 Wilcoxon 秩和检验。所有 P < 0.05 均被视为显著。研究共纳入了 31 名患者。平均随访时间为 16.5 个月(12 至 26.2 个月)。其中1例(3.2%)EHL表面下肌腱撕裂,2例(6.5%)转为MTP融合术,1例(3.2%)因MTP关节挛缩而进行翻修性螯切除术和关节囊松解术。患者的外展ROM(50 vs 89.6度,P=0.002)、术后VAS疼痛评分(6.4 vs 2.1,P<0.001)、MOXFQ疼痛评分(58.1 vs 30.7,P=0.001)均有明显改善。1 vs 30.7,P=0.001)、MOXFQ行走/站立评分(56.6 vs 20.6,P=0.001)、MOXFQ社会交往评分(47.3 vs 19.36,P=0.002)和MOXFQ指数评分(54.7 vs 22.4,P<0.001)。我们发现,MIDC 联合首次 MTP 关节镜手术能有效改善患者一年后的报告结果,且并发症和翻修率较低。这些结果表明,MIDC 联合首次 MTP 关节镜手术是治疗早期 HR 的有效方法。四
Minimally invasive Dorsal cheilectomy and Hallux metatarsophalangeal joint arthroscopy for the treatment of Hallux Rigidus
Background
Minimally invasive dorsal cheilectomy (MIDC) has become a popular alternative to an open approach for treating Hallux Rigidus (HR). To reduce some of the complications related to the MIDC approach, a first metatarsophalangeal (MTP) joint arthroscopy can be performed in addition to address the intra-articular pathology associated with Hallux Rigidus. This study aims to examine the effectiveness of MIDC with first MTP arthroscopy in patients with HR with a minimum 1-year follow-up.
Methods
This was a multicenter retrospective review for adult patients with Coughlin and Shurnass Grade 0–3 who were treated with MIDC and first MTP arthroscopy between 3/1/2020 and 8/1/2022, with at least one year of follow-up data. Demographic information, first MTP range of motion (ROM), visual analog scale (VAS), Manchester-Oxford Foot Questionnaire (MOXFQ), and EQ-5D-5 L scores were collected. Continuous data was expressed as a mean and standard deviation, categorical data was expressed as a percentage. Wilcoxon Rank Sum test was used to compare continuous variables. All P < 0.05 was considered significant.
Results
A total of 31 patients were included in the study. Average follow-up time was 16.5 months (range: 12 to 26.2). There was 1 (3.2%) undersurface EHL tendon tear, 2 (6.5%) conversions to an MTP fusion, and 1 (3.2%) revision cheilectomy and capsular release for MTP joint contracture. There was a significant improvement in patient’s ROM in dorsiflexion (50 vs 89.6 degrees, P = 0.002), postoperative VAS pain scores (6.4 vs 2.1, P < 0.001), MOXFQ pain scores (58.1 vs 30.7, P = 0.001), MOXFQ Walking/Standing scores (56.6 vs 20.6, P = 0.001), MOXFQ Social Interaction scores (47.3 vs 19.36, P = 0.002), and MOXFQ Index scores (54.7 vs 22.4, P < 0.001).
Conclusion
We found that MIDC with first MTP arthroscopy was effective at improving patient-reported outcomes at one year with low complication and revision rates. These results suggest that MIDC with first MTP arthroscopy is an effective treatment for early-stage HR.
期刊介绍:
Foot and Ankle Surgery is essential reading for everyone interested in the foot and ankle and its disorders. The approach is broad and includes all aspects of the subject from basic science to clinical management. Problems of both children and adults are included, as is trauma and chronic disease. Foot and Ankle Surgery is the official journal of European Foot and Ankle Society.
The aims of this journal are to promote the art and science of ankle and foot surgery, to publish peer-reviewed research articles, to provide regular reviews by acknowledged experts on common problems, and to provide a forum for discussion with letters to the Editors. Reviews of books are also published. Papers are invited for possible publication in Foot and Ankle Surgery on the understanding that the material has not been published elsewhere or accepted for publication in another journal and does not infringe prior copyright.