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Arthroplasty with and Without Replacement

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Evidence-Based Bunion Surgery

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Abstract

Hallux valgus and hallux rigidus deformities result in malalignment of the first metatarsophalangeal (MTP) joint that can cause joint cartilage damage and painful arthritis over time. When conservative treatment options or joint salvage procedures fail to relieve symptoms, joint destructive surgery should be considered. The goals of surgery are to alleviate pain and restore function through either joint arthrodesis or arthroplasty. Arthrodesis eliminates motion at the joint and is considered the “gold standard” procedure for end-stage arthritis. However, patients may wish to retain motion at the joint, for occupational or personal reasons, and may be better candidates for an arthroplasty with or without an implant. Arthroplasty techniques for the first MTP joint were first popularized in the late 1800s, but early failures and difficult revisions caused many to shy away from this procedure. The introduction of the implant arthroplasty in the mid-twentieth century reignited interest in its use as evolving designs and materials have improved outcomes while minimizing complications. No particular implant or technique modification to date has proven to restore normal pain-free joint function, but increasing patient satisfaction and function scores have been shown to be as high with an arthroplasty as with an arthrodesis in the right individual.

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Authors and Affiliations

  1. Division of Podiatric Surgery, Mount Auburn Hospital and Harvard Medical School, Crimson Foot and Ankle Specialists, Cambridge, MA, USA

    Emily Cook DPM, MPH

  2. Department of Orthopaedic Surgery, Duke University Medical School, Durham, NC, USA

    Brandon Barrett DPM, MHA

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  1. Emily Cook DPM, MPH
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  2. Brandon Barrett DPM, MHA
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Correspondence to Emily Cook DPM, MPH .

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Editors and Affiliations

  1. College of Podiatric Medicine and Surgery, Des Moines University, Des Moines, Iowa, USA

    Paul D. Dayton

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Cook, E., Barrett, B. (2018). Arthroplasty with and Without Replacement. In: Dayton, P. (eds) Evidence-Based Bunion Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-60315-5_16

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  • DOI: https://doi.org/10.1007/978-3-319-60315-5_16

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