Outcome following first metatarsophalangeal joint replacement using TOEFIT-PLUS™: A mid term alert.
Titchener, Andrew Duncan, Nicholas Rajan, Rohan
Titchener, Andrew
Duncan, Nicholas
Rajan, Rohan
Abstract
BACKGROUND: We aim to evaluate the mid-term results of first metatarsophalangeal joint replacement for hallux rigidus using Toefit-Plus™ in a single surgeon series. METHODS: We prospectively studied the outcomes of 86 toes in 73 patients using the AOFAS-HMI score and radiological follow up. The mean follow up was 33 months (2-72). Ten patients have been lost to follow up. RESULTS: Eight patients sustained intraoperative fractures or impending fractures requiring circlage wiring. Eighteen joints have either been revised or listed for revision giving a revision rate of 24%; this occurred at a mean of 33 months post-surgery. CONCLUSIONS: First MTPJ replacement is an option in hallux rigidus and patients who are not revised experience significant improvement in AOFAS scores in the medium term. We have previously published satisfactory results with this prosthesis. However the revision rate is unacceptably high and we have discontinued its use completely. Future design evolutions should address the issue of osteointegration on the phalangeal side.
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Date
2015-06
Type
Article
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Citation
Foot Ankle Surg. 2015 Jun;21(2):119-24. doi: 10.1016/j.fas.2014.10.005.