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Recreational sport activity after total replacement of the first metatarsophalangeal joint: a prospective study

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Abstract

First metatarsophalangeal joint replacement is an alternative surgical procedure to arthrodesis in the treatment of moderate-to-severe hallux rigidus. However, few studies have been published about functional outcome after joint reconstructive procedures for hallux rigidus. The purpose of this study was to assess clinical, radiological and functional outcome, with special regard to recreational and sports activity, after first metatarsophalangeal joint replacement in patients affected by hallux rigidus grade III. Twenty-three patients who had undergone total joint replacement of the first metatarsophalangeal joint were examined preoperatively and three, six, 12 and 18 months postoperatively. All patients (mean age of 57.0 ± 3.7 years) received a non-cemented TOEFIT-PLUS™ implant by one surgeon. Clinical scores (AOFAS score and VAS), radiological examination, patient satisfaction and sport participation were used to evaluate treatment outcome and radiolucent lines. The mean AOFAS score showed a significant improvement from 44.6 ± 7.2 points preoperatively to an average of 82.5 ± 14.4 points at last follow-up (p < 0.001). The mean total ROM of the first MTP joint increased from 28.1 ± 4.9 degrees preoperatively to 52.7 ± 15.7 degrees postoperatively (p < 0.001). After surgery, 91.3% of the patients were able to resume at least one recreational activity. Total arthroplasty for the treatment of hallux rigidus in an active patient population revealed good clinical and functional results. However, postoperative recreational sport activity showed a decrease in comparison to the pre-arthritic state. Further follow-up is necessary to quantify loosening risk in active patients after total hallux arthroplasty.

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Authors and Affiliations

  1. Klinik und Poliklinik für Allgemeine Orthopädie und Tumororthopädie, Universitätsklinikum Münster, Münster, Germany

    Kiriakos Daniilidis & Georg Gosheger

  2. Department of Orthopaedics and Trauma Surgery, Campus Bio-Medico University of Rome, Via Alvaro del Portillo, 200-00128, Rome, Italy

    Nicolò Martinelli, Andrea Marinozzi & Vincenzo Denaro

  3. Department of Orthopaedic, University Hospital of Vienna, Vienna, Austria

    Ziai Pejman

  4. Department of Orthopeadics, Sporthopaedicum Straubing, Straubing, Germany

    Thomas Buchhorn

Authors
  1. Kiriakos Daniilidis
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  2. Nicolò Martinelli
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  3. Andrea Marinozzi
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  4. Vincenzo Denaro
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  5. Georg Gosheger
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  6. Ziai Pejman
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  7. Thomas Buchhorn
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Correspondence to Nicolò Martinelli.

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Daniilidis, K., Martinelli, N., Marinozzi, A. et al. Recreational sport activity after total replacement of the first metatarsophalangeal joint: a prospective study. International Orthopaedics (SICOT) 34, 973–979 (2010). https://doi.org/10.1007/s00264-009-0935-6

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  • DOI: https://doi.org/10.1007/s00264-009-0935-6

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