Press-fit ceramic implant arthroplasty of the hallux metatarsophalangeal joint—Evaluation of outcomes

Abstract

Objective To evaluate the effectiveness of press-fit ceramic implant arthroplasty of the hallux metatarsophalangeal joint by a composite method. Methods A sample of 6 patients (7 feet) who had undergone ceramic implant arthroplasty of the hallux metatarsophalangeal joint were randomly reviewed. One patient was excluded from the study as he sustained traumatic amputation of the second toe in the operated foot. Subjective and clinical assessments were achieved by employing the American Orthopaedic Foot and Ankle Society hallux metatarsophalangeal-interphalangeal scale. Standard anteroposterior and lateral weight-bearing radiographs were used primarily to assess implant alignment and osteolysis. Foot pressure distribution was analysed using the optical dynamic pedobarograph. Results Subjective and clinical results were satisfactory in all patients. Radiology revealed osteolysis in two cases and varied implant alignment in all patients. Foot pressure analysis showed that normal foot biomechanics was not restored in any of them. Conclusions The present study highlights the need for improved instrumentation during the procedure, to allow greater precision and repeatability. It also questions the suitability of radiographs alone in predicting clinical and subjective outcomes. Ceramic implant arthroplasty, like many other surgical options for the treatment of hallux metatarsophalangeal joint pathology, has failed to restore normal foot biomechanics.