Foot & Ankle International - 2017 FAI Supplement - 24S
revealed significant ability to predict MCS-W for both LFDP
(coefficient=1.12, R2=0.48, p=0.002) and A to P FG (coefficient=2.57, R2=0.52, p=0.001) but not FS (coefficient=0.67,
R2=0.11, p=0.18). When LFDP and A to P FG were combined,
they accounted for 65% of the variability in MCS-W (coefficient=0.70, 1.76; R2=0.65, p=0.033, p=0.018). ROC analysis
for A to P FG using cutoff values of 0.75mm, 1.0mm, and
1.25mm yielded SN and SP of 100% and 75%, 100% and
100%, and 67% and 100%, respectively for each cut point.
Conclusion: The initial fibular displacement is a strong
predictor of medial clear space widening in Weber B ankle
fractures. On lateral radiographs, an anterior to posterior
fibular gap greater than 1.0mm showed a sensitivity and
specificity of 100% in predicting MCS-W=5.0mm. This
provides another tool to aid clinicians in determining the
integrity of the deltoid ligament and may help prevent the
need for further patient discomfort with a stress view.
Revision of Implant to Great Toe
Fusion: Did We "Burn a Bridge" With
a Synthetic Implant Hemiarthroplasty?
Mark Glazebrook, MD, MSc, PhD, Judith
Baumhauer, MD, MPH, MS, Mark Bowen Davies,
MD, FRACS(Orth)
Category: Midfoot/Forefoot
Keywords: synthetic cartilage implant; hemiarthroplasty;
first metatarsophalangeal joint; arthrodesis; revision; outcomes; VAS pain; FAAM; SF-36;
Introduction/Purpose: A prospective, randomized, non-inferiority clinical trial demonstrated that first metatarsophalangeal joint (MTPJ1) hemiarthroplasty with a synthetic
polyvinyl alcohol hydrogel implant (Cartiva®) had equivalent pain relief and functional outcomes to MTPJ1 arthrodesis
at 2 years. Despite 91% success, there was a 9.2% rate of
implant removal and conversion to fusion. Other implants
with more bone resection have demonstrated poorer outcomes
after conversion to fusion than if a primary arthrodesis was
performed. Since bone loss with synthetic cartilage implant
hemiarthroplasty is minimal, we hypothesized that outcomes
following implant removal and conversion to fusion would be
similar to those following primary arthrodesis. We determined
the outcomes of revision of synthetic implant hemiarthroplasty of the great toe to MTPJ1 arthrodesis and compared
these outcomes to the primary arthrodesis cohort.
Methods: In the original pivotal trial, 152 patients >/=18
years diagnosed with hallux rigidus grade 2, 3, or 4 underwent synthetic cartilage implant MTPJ1 hemiarthroplasty,
as previously described (Baumhauer et al., Foot Ankle Int.
2016;37(5):457-69). Outcome measures including the Foot
and Ankle Ability Measure (FAAM), pain visual analogue
scale (VAS), and Short Form-36 Physical Functioning (SF36 PF) score were obtained preoperatively, and at 2 weeks,
6 weeks, and 3, 6, 12 and 24 months postoperatively.
Revision surgery of the MTPJ1 was performed using the
original surgical incision. The medial and lateral capsule
was released, the metatarsal head was exposed to permit
implant removal, and the void was filled with cancellous
autograft or bone graft substitute. Joint compression was
achieved using two crossed screws or a compression plate.
Patients were non-weightbearing for six weeks. Union was
confirmed on radiographs. Patients were followed postconversion and assessed for pain and functional outcomes.
Foot & Ankle International, 38(S1)
DOI: 10.1177/1071100717S00021
©The Author(s) 2017
24S
Results: Fourteen patients (9.2%) underwent implant
removal and conversion to MTPJ1 arthrodesis. Mean time to
revision surgery was 12.8 (range: 1.8-24.2) months. The
removed implants demonstrated no signs of wear,
Foot & Ankle International 38(1S)
Table of Contents for the Digital Edition of Foot & Ankle International - 2017 FAI Supplement
TOC 1
TOC 2
TOC 3
TOC Page 4 + Verso
Editorial Board
President's Introduction
AOFAS Annual Meeting Abstracts 2017
AOFAS Annual Meeting Abstracts 2017
Foot & Ankle International - 2017 FAI Supplement - CT1
Foot & Ankle International - 2017 FAI Supplement - CT2
Foot & Ankle International - 2017 FAI Supplement - Cover1
Foot & Ankle International - 2017 FAI Supplement - Cover2
Foot & Ankle International - 2017 FAI Supplement - i
Foot & Ankle International - 2017 FAI Supplement - TOC 1
Foot & Ankle International - 2017 FAI Supplement - iii
Foot & Ankle International - 2017 FAI Supplement - TOC 2
Foot & Ankle International - 2017 FAI Supplement - 1A
Foot & Ankle International - 2017 FAI Supplement - 1B
Foot & Ankle International - 2017 FAI Supplement - v
Foot & Ankle International - 2017 FAI Supplement - TOC 3
Foot & Ankle International - 2017 FAI Supplement - vii
Foot & Ankle International - 2017 FAI Supplement - TOC Page 4 + Verso
Foot & Ankle International - 2017 FAI Supplement - Editorial Board
Foot & Ankle International - 2017 FAI Supplement - x
Foot & Ankle International - 2017 FAI Supplement - President's Introduction
Foot & Ankle International - 2017 FAI Supplement - AOFAS Annual Meeting Abstracts 2017
Foot & Ankle International - 2017 FAI Supplement - 3S
Foot & Ankle International - 2017 FAI Supplement - 4S
Foot & Ankle International - 2017 FAI Supplement - 5S
Foot & Ankle International - 2017 FAI Supplement - 6S
Foot & Ankle International - 2017 FAI Supplement - 7S
Foot & Ankle International - 2017 FAI Supplement - 8S
Foot & Ankle International - 2017 FAI Supplement - 9S
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Foot & Ankle International - 2017 FAI Supplement - 43S
Foot & Ankle International - 2017 FAI Supplement - 44S
Foot & Ankle International - 2017 FAI Supplement - 45S
Foot & Ankle International - 2017 FAI Supplement - 46S
Foot & Ankle International - 2017 FAI Supplement - AOFAS Annual Meeting Abstracts 2017
Foot & Ankle International - 2017 FAI Supplement - 48S
Foot & Ankle International - 2017 FAI Supplement - 49S
Foot & Ankle International - 2017 FAI Supplement - 50S
Foot & Ankle International - 2017 FAI Supplement - 51S
Foot & Ankle International - 2017 FAI Supplement - 52S
Foot & Ankle International - 2017 FAI Supplement - 53S
Foot & Ankle International - 2017 FAI Supplement - 54S
Foot & Ankle International - 2017 FAI Supplement - Cover3
Foot & Ankle International - 2017 FAI Supplement - Cover4
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_december2020
https://www.nxtbook.com/nxtbooks/sage/psychologicalscience_demo
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_october2020
https://www.nxtbook.com/nxtbooks/sage/fai_202009
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_august2020
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_june2020
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_april2020
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_february2020
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_december2019
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_october2019
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https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_december2018
https://www.nxtbook.com/nxtbooks/sage/tec_20180810
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_october2018
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_julyaugust2018
https://www.nxtbook.com/nxtbooks/sage/fai_201807
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_june2018
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_april2018
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https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_february2018
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_december2017
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_november2017
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_october2017
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_september2017
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_julyaugust2017
https://www.nxtbook.com/nxtbooks/sage/fai_supplement_201709
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_june2017
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_may2017
https://www.nxtbook.com/nxtbooks/sage/fai_201706
https://www.nxtbook.com/nxtbooks/sage/fai_201607
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