Early Versus Delayed Rehabilitation Following First Metatarsophalangeal Joint Implant Arthroplasty: A Retrospective Comparison of 40 Cases.

IF 1.4 4区医学 Q2 Medicine

Journal of Foot & Ankle Surgery Pub Date : 2026-10-29 DOI:10.1053/j.jfas.2026.10.015

Jagoda Głodkowska-Sutuła, Igor Świerkowski

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引用次数: 0

Abstract

Background: First metatarsophalangeal (MTP) joint implant arthroplasty is used to preserve joint mobility and reduce pain in patients with advanced hallux rigidus. The optimal timing of postoperative rehabilitation remains unclear.

Purpose: To compare clinical outcomes associated with early versus delayed rehabilitation following first MTP joint implant arthroplasty.

Study design: Retrospective comparative study.

Methods: Forty patients who underwent first MTP joint implant arthroplasty were analyzed. Twenty initiated rehabilitation immediately after suture removal (mean, 2.1 ± 0.4 weeks after surgery), whereas 20 initiated rehabilitation later (mean, 21.4 ± 3.0 weeks after surgery). Both groups followed the same standardized rehabilitation protocol. Outcomes assessed before and after rehabilitation included dorsiflexion, plantarflexion, pain intensity using the Visual Analog Scale (VAS), and the AOFAS Hallux Score. Group × Time interactions were evaluated using mixed-design ANOVA and linear mixed-effects models adjusted for age and sex.

Results: Greater improvements were observed in the early rehabilitation group for dorsiflexion (+12.35° vs +6.75°), plantarflexion (+4.70° vs +1.70°), VAS (-3.35 vs -1.50), and AOFAS score (+26.90 vs +11.00). Significant Group × Time interactions were found for all outcomes (p ≤ 0.001), and the associations remained significant after adjustment for age and sex.

Conclusions: Early rehabilitation was associated with greater improvements in joint mobility, pain, and functional outcomes than delayed rehabilitation. Given the retrospective, nonrandomized design and differences in postoperative assessment timing, these findings should be interpreted cautiously and confirmed in prospective studies.

Level of evidence: III (Retrospective comparative study).

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首次跖趾关节置换术后早期与延迟康复：40例回顾性比较。

背景：第一跖趾（MTP）关节置换术用于晚期拇趾僵硬患者保持关节活动度和减轻疼痛。术后康复的最佳时机尚不清楚。目的：比较首次MTP关节置换术后早期与延迟康复的临床结果。研究设计：回顾性比较研究。方法：对40例首次行MTP关节置换术的患者进行分析。20例术后立即开始康复（平均术后2.1±0.4周），20例术后开始康复（平均术后21.4±3.0周）。两组都遵循相同的标准化康复方案。康复前后评估的结果包括背屈、跖屈、疼痛强度（使用视觉模拟量表（VAS））和AOFAS拇趾评分。使用混合设计方差分析和调整年龄和性别的线性混合效应模型评估时间相互作用。结果：早期康复组在背屈度（+12.35°vs +6.75°）、跖屈度（+4.70°vs +1.70°）、VAS（-3.35°vs -1.50）和AOFAS评分（+26.90 vs +11.00）方面均有较大改善。组 × 所有结果均存在时间交互作用（p≤0.001），在调整年龄和性别后，相关性仍然显著。结论：与延迟康复相比，早期康复在关节活动度、疼痛和功能预后方面有更大的改善。考虑到回顾性、非随机设计和术后评估时间的差异，这些发现应谨慎解释，并在前瞻性研究中得到证实。证据水平：III（回顾性比较研究）。

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 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.