Long term follow-up on metatarsophalangeal joint ar-throplasty with implantation of Osteomed Interflex IPG system

Abstract

Purpose: in this observational study we report our 6-years experience (from April 2009 to July 2015) of 75 implants using the Osteomed Interflex IPJ system specifically designed for replacement of metatarso-phalangeal joints of the lesser toes, all performed in our clinic. Methods: 56 patients (51 women and 5 men; median age around 63 yrs, range 50-78 yrs). 41 arthroplasties were implanted on the right side whereas 34 on the left side. In 37 patients we implanted the IPJ prosthesis for the II metatarso-phalangeal joint (MTF), whereas in 19 patients we additionally substituted the III MTF joint. In 45 patients, we also performed surgical osteotomy for associated moderate to severe hallux valgus deformity in the same operating time. The average follow-up was 50,7 months. Results: in a long term follow-up period, no patients experienced intolerance of the implant and all patients regained the ability to walk without feeling any pain at the ball of the foot. We didn’t experience any intra-operative complications. Post-operative complications were 2 post-traumatic arthroplasty mobilizations in patients who underwent 2 implants simultaneously and 2 separated cases of surgical wound dehiscence recovered in 35 days and 60 days. Discussion and conclusions: according to us and given this long term follow-up period, this surgical replacement is a good solution in selected cases of metatarso-phalangeal deformity. Moreover, the addition of hallux valgus osteotomy to the MTF substitution in the same surgical procedure could conceivably increase overall foot performance and could surely save another separate intervention to the patient.