Advertisement

Interpositional Arthroplasty for the First Metatarsophalangeal Joint

  • Patrick E. Bull
  • James M. Cottom
  • Geoffrey Landis
Chapter

Abstract

Treatment of advanced first metatarsophalangeal joint (MTPJ) arthritis has many options. Choosing the appropriate treatment strategy for first MTPJ arthritis is dependent upon many factors. The use of an interpositional arthroplasty is an attractive option for younger and active patients with severe (Coughlin and Shurnas Grade III and IV) MTPJ arthritis as it preserves motion and avoids the activity limitations, restricted shoewear options, and stiffness associated with arthrodesis. Interposition arthroplasty procedures allow the surgeon to successfully address both the pain and discomfort resultant from arthritic first MTPJ changes without compromising joint bone stock, metatarsal length, and joint stability as are commonly encountered after joint hemi- and total arthroplasty. Furthermore, joint arthrodesis complications such as nonunion, among others, are avoided. In addition, interposition arthroplasty techniques allow for future arthroplasty or arthrodesis at a later date should further joint deterioration occur. Lastly, our technique also resurfaces the metatarsosesamoid joints, which are left untreated by nearly all other surgical treatments and have potential to produce postoperative pain. In this chapter we will review our preferred method for first MTPJ interpositional arthroplasty utilizing an allograft regenerative tissue matrix (RTM).

References

  1. 1.
    Coughlin MJ, Shurnas PS. Hallux rigidus. Grading and long-term results of operative treatment. J Bone Joint Surg Am. 2003;85-A(11):2072–88.CrossRefGoogle Scholar
  2. 2.
    Berlet GC, Hyer CF, Lee TH, Philbin TM, Hartman JF, Wright ML. Interpositional arthroplasty of the first MTP joint using a regenerative tissue matrix for the treatment of advanced hallux rigidus. Foot Ankle Int. 2008;29(1):10–21.CrossRefGoogle Scholar
  3. 3.
    Brage ME, Ball ST. Surgical options for salvage of end-stage hallux rigidus. Foot Ankle Clin. 2002;7(1):49–73.CrossRefGoogle Scholar
  4. 4.
    Coughlin MJ, Shurnas PJ. Soft-tissue arthroplasty for hallux rigidus. Foot Ankle Int. 2003;24(9):661–72.CrossRefGoogle Scholar
  5. 5.
    Hamilton WG, O’malley MJ, Thompson FM, Kovatis PE, Roger Mann Award 1995. Capsular interposition arthroplasty for severe hallux rigidus. Foot Ankle Int. 1997;18(2):68–70.CrossRefGoogle Scholar
  6. 6.
    Johnson JE, Mccormick JJ. Modified oblique Keller capsular interposition arthroplasty (MOKCIA) for treatment of late-stage hallux rigidus. Foot Ankle Int. 2014;35(4):415–22.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Patrick E. Bull
    • 1
  • James M. Cottom
    • 2
  • Geoffrey Landis
    • 3
  1. 1.Orthopedic Foot & Ankle CenterWorthingtonUSA
  2. 2.Florida Orthopedic Foot & Ankle CenterSarasotaUSA
  3. 3.Northwest Medical Center/Oro Valley Hospital, Department of Orthopedic SurgeryTucsonUSA

Personalised recommendations