Physical Function and Pain Interference Levels of Hallux Rigidus Patients Before and After Synthetic Cartilage Implant vs Arthrodesis Surgery

doi:10.1177/10711007211007843

Paper

Physical Function and Pain Interference Levels of Hallux Rigidus Patients Before and After Synthetic Cartilage Implant vs Arthrodesis Surgery

Published May 24, 2021 · P. Joo, J. Baumhauer, Olivia V. Waldman

Foot & Ankle International

Q1 SJR score

7

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1

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Abstract

Background: Hallux rigidus is a common and painful degenerative condition of the great toe limiting a patient’s physical function and quality of life. The purpose of this study was to investigate pre- and postoperative physical function (PF) and pain interference (PI) levels of patients undergoing synthetic cartilage implant hemiarthroplasty (SCI) vs arthrodesis (AD) for treatment of hallux rigidus using the Patient-Reported Outcomes Measurement Information System (PROMIS). Methods: PROMIS PF and PI t scores were analyzed for patients who underwent either SCI or AD. Postoperative final PROMIS t scores were obtained via phone survey. Linear mixed model analysis was used to assess differences in PF and PI at each follow-up point. Final follow-up scores were analyzed using independent sample t tests. Results: Total 181 (59 SCI, 122 AD) operatively managed patients were included for analysis of PROMIS scores. Final phone survey was performed at a minimum of 14 (mean 33, range, 14-59) months postoperatively, with 101 patients (40 SCI, 61 AD) successfully contacted. The mean final follow-up was significantly different for SCI and AD: 27 vs 38 months, respectively (P < .01). The mean age of the SCI cohort was lower than the AD cohort (57.5 vs 61.5 years old, P = .01). Average PF t scores were higher in the SCI cohort at baseline (47.1 and 43.9, respectively, P = .01) and at final follow-up (51.4 vs 45.9, respectively, P < .01). A main effect of superior improvement in PF was noted in the SCI group (+4.3) vs the AD group (+2) across time intervals (P < .01). PI t scores were similar between the 2 procedures across time points. Conclusion: The SCI cohort reported slightly superior PF t scores preoperatively and at most follow-up time points compared with the arthrodesis group. No differences were found for PI or complication rates between the 2 treatment groups during this study time frame. Level of Evidence: Level IV, case series.

Observational Study

Study Snapshot

Synthetic cartilage implant hemiarthroplasty (SCI) for hallux rigidus patients showed slightly superior physical function improvement compared to arthrodesis, with no significant differences in pain interference or complication rates.

PopulationOlder adults (50-71 years)

Sample size24

MethodsObservational

OutcomesBody Mass Index projections

ResultsSocial networks mitigate obesity in older groups.

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Paper

Physical Function and Pain Interference Levels of Hallux Rigidus Patients Before and After Synthetic Cartilage Implant vs Arthrodesis Surgery

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References

Cost Comparison of Synthetic Hydrogel Implant and First Metatarsophalangeal Joint Arthrodesis

Synthetic hydrogel implant treatment for hallux rigidus resulted in a higher direct aggregate cost than MTP arthrodesis, making it less cost-effective.

Comparison Between Polyvinyl Alcohol Implant and Cheilectomy With Moberg Osteotomy for Hallux Rigidus

The addition of a PVA implant to cheilectomy with Moberg osteotomy for hallux rigidus patients resulted in superior clinical and patient-reported outcomes compared to traditional joint-preserving procedures.

Clinical Outcomes of the Polyvinyl Alcohol (PVA) Hydrogel Implant for Hallux Rigidus

The PVA hydrogel implant for hallux rigidus hemiarthroplasty significantly improves physical function and pain scores, with excellent survivorship in the first 2 years postoperatively.

Outcomes of Polyvinyl Alcohol Hydrogel Implant of the Lesser Metatarsals

The PVA hydrogel implant is a viable option for treating lesser toe metatarsophalangeal joint pathology, improving pain intensity and interference, but complications may occur.

Pattern of recovery and outcomes of patient reported physical function and pain interference after ankle fusion: a retrospective cohort study

Average ankle fusion patients experience clinically meaningful improvement in pain more than physical function, with recovery plateauing at 4 months postoperatively.

Citations

A Comparison of PROMIS Scores of Metatarsophalangeal Joint Arthrodesis and Polyvinyl Alcohol Hydrogel Implant Hemiarthroplasty for Hallux Rigidus

MTP joint arthrodesis provides better pain relief and overall health outcomes compared to SCI hemiarthroplasty for hallux rigidus treatment.

Cartiva interpositional arthroplasty versus arthrodesis in the treatment of Hallux rigidus: A retrospective comparative study with mean 2 year follow up.

Cartiva SCI interpositional arthroplasty showed no significant superiority over arthrodesis in terms of patient-reported outcomes, and arthrodesis remains the preferred surgical option for hallux rigidus.

Surgical Outcomes of Synthetic Cartilage Implant Hemiarthroplasty for Metatarsophalangeal Arthropathy

Cartiva surgery for metatarsophalangeal arthropathy has shown persistent pain, limited range of movement, and restricted function at short-term follow-up, with comparable reoperation and revision rates to similar studies.

"In-Situ" Joint Preparation Technique for 1st Metatarsophalangeal Arthrodesis: A retrospective comparative review of 388 cases.

The "in-situ" joint preparation technique is a simple and effective method for first metatarsophalangeal joint arthrodesis, with a higher radiographic nonunion rate but similar revision rates and patient-reported outcomes.

Effect of Prior Cheilectomy on Outcomes of First Metatarsophalangeal Joint Fusion for Treatment of Hallux Rigidus

A prior failed cheilectomy does not influence the amount of improvement in function and pain from metatarsophalangeal joint fusion for hallux rigidus.