A new study surveyed 60 patients who had been treated with triplane metatarsal phalangeal joint arthrodesis to see how well they were doing post operatively.
How Well Does Metatarsophalangeal Joint Arthrodesis Work?
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The results of that surgery, “What Do Patients Report Regarding Their Real-World Function Following Triplane Metatarsophalangeal Joint Arthrodesis for Hallux Valgus,” was published online July 19, 2022 in the Journal of Foot & Ankle Surgery.
According to the multicenter, largely midwestern U.S. research team, “First metatarsal phalangeal joint arthrodesis has been employed for decades for pain related to arthritis and other associated abnormalities. Despite the commonality of the procedure there continues to be questions regarding functional expectations following the procedure especially when employed for correction of hallux valgus deformity.”
The researchers surveyed 60 patients who had a triplane metatarsal phalangeal joint arthrodesis at, on average, 2 years and 4.4 months (median 27.8 months) after surgery and collected data about each patient’s daily living and sports activity. The surveys were conducted through face-to-face conversations.
Ninety-seven percent of the patients told the research team that they were able to walk without restrictions and or pain. “Ninety-eight percent were able to walk at a normal pace. Ninety-five percent reported a loss of motion of their big toe but that it did not affect their daily function.”
In addition, all the participants who participated in sports before surgery were able to return to sport after with a trend toward increased sports activity. They also noted they had an “early return to walking in a fracture boot at mean 4.1 days, return to athletic shoe at mean 6.3 weeks and full unrestricted activity at mean 13.3 weeks with no non-unions.”
“Deformity correction of the typical components of hallux valgus deformity were similar to previously published studies. This data set supports the hypothesis that patients undergoing metatarsal phalangeal joint arthrodesis can expect rapid and full return to activities of daily living and sports with a low complication rate,” the researchers wrote.
Study authors include Mindi Dayton, DPM, MHA, FACFAS, and Paul Dayton, DPM,MS, FACFAS, both from Bunion Surgery Specialists in Ankeny, Iowa. Cody J Togher, DPM, AACFAS, and John M. Thompson, DPM, AACFAS, of Orthopedic Foot & Ankle Center in Worthington, Ohio, also contributed to the research.
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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