Artrodese versus artroplastia da primeira articulação metatarsofalângica no tratamento do hallux rigidus – Estudo comparativo de pacientes selecionados apropriadamente
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.16/2706 |
Resumo: | Objective Historical results of arthroplasty of the first metatarsophalangeal joint (1MTP) are relatively poor; however, improvements in the understanding of the normal foot biomechanics, implant materials and design currently make arthroplasty a reasonable option in appropriately selected patients. The present study aimed to compare the clinical and radiographic results of 1MTP arthrodesis and arthroplasty in the treatment of hallux rigidus and to present a rationale for patient selection for arthroplasty. Methods A total of 36 patients (38 feet) with hallux rigidus submitted to surgery (12 arthrodesis and 26 arthroplasties) were prospectively included in the study. Pain was assessed using the visual analogue scale (VAS) and the functional status was assessed using the American Orthopedic Foot and Ankle Society Hallux Metatarsophalangeal-Interphalangeal (AOFAS-HMI) scale. Complications and radiographic results were also analyzed, and survival rates were calculated for both procedures. Results All of the patients reported significant improvement in pain and functional status after surgery. Patients submitted to arthroplasty had better functional results on the AOFAS-HMI scale (89.7 versus 65.7 points; p < 0.001) and better pain relief (VAS 1.6 versus 3.9 points; p = 0.002) when compared with the group submitted to arthrodesis. There was one case of infection in the arthroplasty group and 2 cases of pseudarthrosis in the arthrodesis group. Conclusion Arthrodesis provides pain relief and satisfactory results but alters the biomechanics of gait. Like arthrodesis, arthroplasty improves pain significantly, being a more physiological alternative to preserve the biomechanics of the foot. While the two surgical methods yielded good clinical results, selected patients submitted to arthroplasty had better clinical scores and lower revision rates. |
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Artrodese versus artroplastia da primeira articulação metatarsofalângica no tratamento do hallux rigidus – Estudo comparativo de pacientes selecionados apropriadamenteArtrodese versus artroplastia da primeira articulação metatarsofalângica no tratamento do hallux rigidus – Estudo comparativo de pacientes selecionados apropriadamentearthrodesisarthroplastycomparative studyhallux rigidusjoint replacementObjective Historical results of arthroplasty of the first metatarsophalangeal joint (1MTP) are relatively poor; however, improvements in the understanding of the normal foot biomechanics, implant materials and design currently make arthroplasty a reasonable option in appropriately selected patients. The present study aimed to compare the clinical and radiographic results of 1MTP arthrodesis and arthroplasty in the treatment of hallux rigidus and to present a rationale for patient selection for arthroplasty. Methods A total of 36 patients (38 feet) with hallux rigidus submitted to surgery (12 arthrodesis and 26 arthroplasties) were prospectively included in the study. Pain was assessed using the visual analogue scale (VAS) and the functional status was assessed using the American Orthopedic Foot and Ankle Society Hallux Metatarsophalangeal-Interphalangeal (AOFAS-HMI) scale. Complications and radiographic results were also analyzed, and survival rates were calculated for both procedures. Results All of the patients reported significant improvement in pain and functional status after surgery. Patients submitted to arthroplasty had better functional results on the AOFAS-HMI scale (89.7 versus 65.7 points; p < 0.001) and better pain relief (VAS 1.6 versus 3.9 points; p = 0.002) when compared with the group submitted to arthrodesis. There was one case of infection in the arthroplasty group and 2 cases of pseudarthrosis in the arthrodesis group. Conclusion Arthrodesis provides pain relief and satisfactory results but alters the biomechanics of gait. Like arthrodesis, arthroplasty improves pain significantly, being a more physiological alternative to preserve the biomechanics of the foot. While the two surgical methods yielded good clinical results, selected patients submitted to arthroplasty had better clinical scores and lower revision rates.ThiemeRepositório Científico do Centro Hospitalar Universitário de Santo AntónioSantos Silva, MartaRodrigues-Pinto, RicardoBarros, Luís H.Sousa, ArnaldoMuras, José2022-07-12T10:21:43Z20202020-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.16/2706engSantos Silva M, Rodrigues-Pinto R, Barros LH, Sousa A, Muras J. Arthrodesis versus Arthroplasty of the First Metatarsophalangeal Joint in the Treatment of Hallux Rigidus - A Comparative Study of Appropriately Selected Patients. Rev Bras Ortop (Sao Paulo). 2020;55(1):40-47. doi:10.1055/s-0039-17008150102-361610.1055/s-0039-1700815info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-10-20T11:01:50Zoai:repositorio.chporto.pt:10400.16/2706Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T20:38:53.981789Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Artrodese versus artroplastia da primeira articulação metatarsofalângica no tratamento do hallux rigidus – Estudo comparativo de pacientes selecionados apropriadamente Artrodese versus artroplastia da primeira articulação metatarsofalângica no tratamento do hallux rigidus – Estudo comparativo de pacientes selecionados apropriadamente |
title |
Artrodese versus artroplastia da primeira articulação metatarsofalângica no tratamento do hallux rigidus – Estudo comparativo de pacientes selecionados apropriadamente |
spellingShingle |
Artrodese versus artroplastia da primeira articulação metatarsofalângica no tratamento do hallux rigidus – Estudo comparativo de pacientes selecionados apropriadamente Santos Silva, Marta arthrodesis arthroplasty comparative study hallux rigidus joint replacement |
title_short |
Artrodese versus artroplastia da primeira articulação metatarsofalângica no tratamento do hallux rigidus – Estudo comparativo de pacientes selecionados apropriadamente |
title_full |
Artrodese versus artroplastia da primeira articulação metatarsofalângica no tratamento do hallux rigidus – Estudo comparativo de pacientes selecionados apropriadamente |
title_fullStr |
Artrodese versus artroplastia da primeira articulação metatarsofalângica no tratamento do hallux rigidus – Estudo comparativo de pacientes selecionados apropriadamente |
title_full_unstemmed |
Artrodese versus artroplastia da primeira articulação metatarsofalângica no tratamento do hallux rigidus – Estudo comparativo de pacientes selecionados apropriadamente |
title_sort |
Artrodese versus artroplastia da primeira articulação metatarsofalângica no tratamento do hallux rigidus – Estudo comparativo de pacientes selecionados apropriadamente |
author |
Santos Silva, Marta |
author_facet |
Santos Silva, Marta Rodrigues-Pinto, Ricardo Barros, Luís H. Sousa, Arnaldo Muras, José |
author_role |
author |
author2 |
Rodrigues-Pinto, Ricardo Barros, Luís H. Sousa, Arnaldo Muras, José |
author2_role |
author author author author |
dc.contributor.none.fl_str_mv |
Repositório Científico do Centro Hospitalar Universitário de Santo António |
dc.contributor.author.fl_str_mv |
Santos Silva, Marta Rodrigues-Pinto, Ricardo Barros, Luís H. Sousa, Arnaldo Muras, José |
dc.subject.por.fl_str_mv |
arthrodesis arthroplasty comparative study hallux rigidus joint replacement |
topic |
arthrodesis arthroplasty comparative study hallux rigidus joint replacement |
description |
Objective Historical results of arthroplasty of the first metatarsophalangeal joint (1MTP) are relatively poor; however, improvements in the understanding of the normal foot biomechanics, implant materials and design currently make arthroplasty a reasonable option in appropriately selected patients. The present study aimed to compare the clinical and radiographic results of 1MTP arthrodesis and arthroplasty in the treatment of hallux rigidus and to present a rationale for patient selection for arthroplasty. Methods A total of 36 patients (38 feet) with hallux rigidus submitted to surgery (12 arthrodesis and 26 arthroplasties) were prospectively included in the study. Pain was assessed using the visual analogue scale (VAS) and the functional status was assessed using the American Orthopedic Foot and Ankle Society Hallux Metatarsophalangeal-Interphalangeal (AOFAS-HMI) scale. Complications and radiographic results were also analyzed, and survival rates were calculated for both procedures. Results All of the patients reported significant improvement in pain and functional status after surgery. Patients submitted to arthroplasty had better functional results on the AOFAS-HMI scale (89.7 versus 65.7 points; p < 0.001) and better pain relief (VAS 1.6 versus 3.9 points; p = 0.002) when compared with the group submitted to arthrodesis. There was one case of infection in the arthroplasty group and 2 cases of pseudarthrosis in the arthrodesis group. Conclusion Arthrodesis provides pain relief and satisfactory results but alters the biomechanics of gait. Like arthrodesis, arthroplasty improves pain significantly, being a more physiological alternative to preserve the biomechanics of the foot. While the two surgical methods yielded good clinical results, selected patients submitted to arthroplasty had better clinical scores and lower revision rates. |
publishDate |
2020 |
dc.date.none.fl_str_mv |
2020 2020-01-01T00:00:00Z 2022-07-12T10:21:43Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.16/2706 |
url |
http://hdl.handle.net/10400.16/2706 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Santos Silva M, Rodrigues-Pinto R, Barros LH, Sousa A, Muras J. Arthrodesis versus Arthroplasty of the First Metatarsophalangeal Joint in the Treatment of Hallux Rigidus - A Comparative Study of Appropriately Selected Patients. Rev Bras Ortop (Sao Paulo). 2020;55(1):40-47. doi:10.1055/s-0039-1700815 0102-3616 10.1055/s-0039-1700815 |
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info:eu-repo/semantics/openAccess |
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openAccess |
dc.format.none.fl_str_mv |
application/pdf |
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Thieme |
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Thieme |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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