TOEFIT-PLUS™ replacement of the first metatarsophalangeal joint of the first toe: A short-term follow-up study

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Osteoarthritis of the metatarsophalangeal joint is normally treated with arthrodesis or resection arthroplasty. Metallic replacement of these joints is sometimes used but is not widely accepted. The use of silastic joints is associated with synovitis and implant failure. In this study, our goal was to measure and evaluate the results of metatarsophalangeal replacement with TOEFIT-PLUS™ (Plus Orthopedics AG, Switzerland) arthroplasty. The implant consists of metatarsal and phalangeal components with polyethylene inserts. We prospectively recruited 20 patients (13 female, 7 male) with an average age of 57 years. Mean follow-up time was 12.2 months (S.D. 5.4, range of 6–21 months). Criteria for the selection of joint replacement were mainly pain, loss of motion, and radiological changes. Clinical assessment was based on the MTP-interphalangeal score of the American Orthopaedic Foot and Ankle Society (AOFAS). Twenty cases of arthritis of the metatarsophalangeal joints were treated surgically with TOEFIT-PLUS™ replacement of the joint. All patients had release of the soft tissue on the plantar side. Short-term follow-up of average 12 months showed good improvement in clinical symptoms (pain and function), improvement in foot scores, and 90% patient-reported satisfaction with the operative results. Range of motion was average 16.35° of plantar flexion and 16.05° of dorsiflexion. A longer follow-up period is required to gauge the long-term survivorship of the TOEFIT-PLUS™ system.