Artrodese versus artroplastia da primeira articulação metatarsofalângica no tratamento do hallux rigidus – Estudo comparativo de pacientes selecionados apropriadamente

Santos Silva, Marta; Rodrigues-Pinto, Ricardo; Barros, Luís H.; Sousa, Arnaldo; Muras, José

Publication

Artrodese versus artroplastia da primeira articulação metatarsofalângica no tratamento do hallux rigidus – Estudo comparativo de pacientes selecionados apropriadamente

2020Journal article

dc.contributor.author	Santos Silva, Marta
dc.contributor.author	Rodrigues-Pinto, Ricardo
dc.contributor.author	Barros, Luís H.
dc.contributor.author	Sousa, Arnaldo
dc.contributor.author	Muras, José
dc.date.accessioned	2022-07-12T10:21:43Z
dc.date.available	2022-07-12T10:21:43Z
dc.date.issued	2020
dc.description.abstract	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.	pt_PT
dc.description.version	info:eu-repo/semantics/publishedVersion	pt_PT
dc.identifier.citation	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	pt_PT
dc.identifier.doi	10.1055/s-0039-1700815	pt_PT
dc.identifier.issn	0102-3616
dc.identifier.issn	1982-4378
dc.identifier.uri	http://hdl.handle.net/10400.16/2706
dc.language.iso	eng	pt_PT
dc.peerreviewed	yes	pt_PT
dc.publisher	Thieme	pt_PT
dc.relation.publisherversion	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7051855/pdf/10-1055-s-0039-1700815.pdf	pt_PT
dc.rights.uri	http://creativecommons.org/licenses/by-nc/4.0/	pt_PT
dc.subject	arthrodesis	pt_PT
dc.subject	arthroplasty	pt_PT
dc.subject	comparative study	pt_PT
dc.subject	hallux rigidus	pt_PT
dc.subject	joint replacement	pt_PT
dc.title	Artrodese versus artroplastia da primeira articulação metatarsofalângica no tratamento do hallux rigidus – Estudo comparativo de pacientes selecionados apropriadamente	pt_PT
dc.title.alternative	Artrodese versus artroplastia da primeira articulação metatarsofalângica no tratamento do hallux rigidus – Estudo comparativo de pacientes selecionados apropriadamente	pt_PT
dc.type	journal article
dspace.entity.type	Publication
oaire.citation.conferencePlace	Germany	pt_PT
oaire.citation.endPage	047	pt_PT
oaire.citation.issue	01	pt_PT
oaire.citation.startPage	040	pt_PT
oaire.citation.title	Revista Brasileira de Ortopedia	pt_PT
oaire.citation.volume	55	pt_PT
person.familyName	Rodrigues-Pinto
person.givenName	Ricardo
person.identifier.ciencia-id	221F-996E-52A5
person.identifier.orcid	0000-0002-6903-348X
person.identifier.scopus-author-id	54981067800
rcaap.rights	openAccess	pt_PT
rcaap.type	article	pt_PT
relation.isAuthorOfPublication	40b26cca-90ca-47d6-9bbb-a14d37b9772c
relation.isAuthorOfPublication.latestForDiscovery	40b26cca-90ca-47d6-9bbb-a14d37b9772c