Four-year outcomes following triplanar tarsometatarsal arthrodesis with early weightbearing for Hallux Valgus: A multicenter prospective study.

IF 1.3 4区 医学 Q2 Medicine
Daniel J Hatch, Avneesh Chhabra, Mindi Dayton, Paul D Dayton, Daniel C Farber, Deidre A Kile, Jennifer Koay, George T Liu, Jody P McAleer, Robert D Santrock
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引用次数: 0

Abstract

Background: Traditional hallux valgus surgery has been focused on two-dimensional repair with high reported recurrence rates.

Purpose: We report the 4-year interim analysis of a prospective, 5-year, multicenter study of radiographic, clinical, and patient-reported outcomes following triplanar first tarsometatarsal arthrodesis with early weightbearing.

Study design: This is a prospective, multicenter, clinical trial involving 7 US-based centers and 13 surgeons. One-hundred and seventy-three patients were treated, of whom 139 (80.3%) achieved their 48-month visit. Clinical and radiographic parameters were evaluated at all follow-up visits along with patient-reported outcomes [Visual Analog Scale (VAS), Manchester-Oxford Foot Questionnaire (MOxFQ) and Patient-Reported Outcomes Measurement Information System (PROMIS).

Methods: Institutional review board approval was obtained for each study site. A consecutive cohort of patients were enrolled from November 2018 to April 2021 who received first TMT arthrodesis to correct their symptomatic hallux valgus. Inclusion and exclusion criteria were established.

Results: Significant improvements in triplanar radiographic correction (hallux valgus angle, intermetatarsal angle, tibial sesamoid position, sagittal-plane IMA, and osseous foot width) were maintained at all timepoints. Using recurrence definitions of > 15° and 20° postoperative hallux valgus angle, recurrence rates were 8.4% (95% CI:4.27%, 14.53%) and 0.8% (95% CI:0.02%, 4.18%) at 48 months, respectively. Mean (95% CI) time to weightbearing in a boot walker was 7.7 (6.6, 8.8) days.

Conclusion: The 4-year interim results of this prospective, multicenter study demonstrate favorable improvement of the triplanar hallux valgus deformity, maintenance of correction, low complication rate, and favorable patient-reported outcomes with early return to protected weightbearing.

三平面跗跖关节融合术早期负重治疗拇外翻的四年疗效:一项多中心前瞻性研究。
背景:传统的拇外翻手术以二维修复为主,复发率高。目的:我们报告了一项为期4年的前瞻性、5年、多中心研究的中期分析,研究了早期负重的第一跗跖关节融合术后的影像学、临床和患者报告的结果。研究设计:这是一项前瞻性、多中心临床试验,涉及7个美国中心和13名外科医生。173例患者接受了治疗,其中139例(80.3%)完成了48个月的随访。在所有随访中评估临床和放射学参数以及患者报告的结果[视觉模拟量表(VAS),曼彻斯特-牛津足问卷(MOxFQ)和患者报告的结果测量信息系统(PROMIS)]。方法:每个研究地点都获得了机构审查委员会的批准。2018年11月至2021年4月,连续招募了一组接受首次TMT关节融合术以纠正症状性外翻的患者。建立了纳入和排除标准。结果:三平面放射矫正(拇外翻角、跖间角、胫骨籽骨位置、矢状面IMA和骨足宽度)在所有时间点均保持显著改善。采用术后拇外翻角> 15°和20°的复发定义,48个月的复发率分别为8.4% (95% CI:4.27%, 14.53%)和0.8% (95% CI:0.02%, 4.18%)。行走靴到负重的平均(95% CI)时间为7.7(6.6,8.8)天。结论:这项前瞻性、多中心研究的4年中期结果显示,拇外翻三面畸形得到了良好的改善,矫正得以维持,并发症发生率低,患者报告的早期恢复保护负重的良好结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Foot & Ankle Surgery
Journal of Foot & Ankle Surgery ORTHOPEDICS-SURGERY
CiteScore
2.30
自引率
7.70%
发文量
234
审稿时长
29.8 weeks
期刊介绍: The Journal of Foot & Ankle Surgery is the leading source for original, clinically-focused articles on the surgical and medical management of the foot and ankle. Each bi-monthly, peer-reviewed issue addresses relevant topics to the profession, such as: adult reconstruction of the forefoot; adult reconstruction of the hindfoot and ankle; diabetes; medicine/rheumatology; pediatrics; research; sports medicine; trauma; and tumors.
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