Preservation of joint movement and good pain relief with early mobilization were the advantages of this procedure. This total first MTP joint prosthesis yielded good functional outcome and high patient satisfaction level with low early complication rate. No revision was required for any of the patients during the follow-up period. No radiologic loosening was found, but radiolucency was observed in 2 patients with this implant. The average MTP joint range of motion improved from 25.9 degrees preoperatively to 53.8 degrees at the final follow-up. Preoperative average visual analogue scale pain scores improved from 7.4 preoperatively to 1.9 at the final follow-up (P <. Mean preoperative AOFAS score improved from 42.7 (range: 36 to 59) to 88.5 (range: 59 to 98) at the final follow-up (P <. Pain was assessed with the use of a visual analogue scale. Postoperative satisfaction and function were scored according to the American Orthopaedic Foot and Ankle Society (AOFAS) score. All patients were evaluated clinically and radiographically. The average follow-up time was 29.9 (range: 25 to 62) months. The aim of our study was to evaluate the early results of the ToeFit-Plus prosthesis for the treatment of HR.īetween December 2007 and January 2011, a total of 26 toes of 24 patients with MTP arthritis of the great toe were treated with ToeFit-Plus implant. Based on our results, MTP1 replacement should be indicated restrictively (hallux rigidus, no experiments in cases of important first ray insufficiency).Īlthough metatarsophalangeal (MTP) arthrodesis has been advocated by many authors, implant arthroplasty appears to be successful option in advanced hallux rigidus (HR). A more aggressive postoperative treatment with early weight bearing and regular push-off of the first ray is recommended. Of 11 cases (63%) with a 4-year follow-up, 7 revealed secondary loss of range of motion. In 3 of 14 cases (21%) with a 3-year follow-up, revision surgery was necessary (subluxation, persistent pain, recurrence of hallux rigidus). Five complications (16.6%) included two dislocations of total prostheses and three bone fissures. Furthermore the authors report their results with 30 Toefit-Plus total endoprostheses. Some currently available models are described (Toefit-Plus, Roto-glide, ReFlexion, Bio-Action, Moje). Nevertheless, better understanding of biomechanics and tribology show favour towards total endoprosthesis.
Prospective studies concerning endoprosthetic replacement of the MTP1 joint are not available yet.
Replacement of the first metatarsophalangeal joint (MTP1) is still controversial when compared with MTP1 fusion in treating hallux rigidus and other disabling conditions of the MTP1 joint.
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