Background

Hallux rigidus (HR) is a degenerative arthritis of the first metatarsophalangeal joint (MTP1) with progressive loss of range of movement (ROM). Interposition arthroplasty (IA) is a technique widely used for the treatment of HR;however, few studies reported long-term clinical results. This study aims to report the clinical results of IA using a bovine pericardium collagen matrix for HR with a minimum 10-years follow-up.

Methods

Thirty patients (31 feet) who underwent IA using a bovine pericardium collagen matrix from 2001 to 2009 were retrospectively evaluated with a mean follow up of 154.1 ± 28.6 (range 124–218) months. All HR ranged from grade II to grade III, according to Regnauld classification. All patients were clinically assessed with the American Orthopedic Foot and Ankle Society Hallux Metatarsophalangeal- Interphalangeal Scale, a pain Visual Analog Scale, and the Foot and Ankle Disability Index. Scores before and after treatment, respectively achieved from clinical records and clinical evaluation at final follow-up were compared.

Results

At final follow-up, an improvement of all the considered scores (p < 0.01) was recorded. The overall rate of unsatisfying results was 16.1 %. Two (6.4 %) patients complained discomfort due to first ray shortening and 3 (9.7 %) cases of persistent metatarsal pain. There was one (3.2 %) case of Complex Regional Pain Syndrome (CPRS). No revision surgeries, infection, or other adverse events were reported.Conclusion: Interposition arthroplasty using bovine collagenous membrane is a reliable solution for high-grade HR with durable results over 10 years in more than 80 % of patients.

中文翻译：

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牛胶原膜关节置换术治疗拇趾僵硬：一项长期结果回顾性研究

背景

拇趾僵硬(HR) 是第一跖趾关节 (MTP1) 的退行性关节炎，伴有运动范围 (ROM) 的进行性丧失。关节置换术 ( Interposition arthroplasty, IA) 是一种广泛用于治疗 HR 的技术；然而，很少有研究报告长期临床结果。本研究旨在报告 IA 使用牛心包胶原基质进行 HR 至少 10 年随访的临床结果。

方法

对 2001 年至 2009 年使用牛心包胶原基质接受 IA 的 30 名患者（31 英尺）进行了回顾性评估，平均随访时间为 154.1 ± 28.6（范围 124-218）个月。根据 Regnauld 分类，所有 HR 的范围从 II 级到 III 级。所有患者均使用美国足踝骨科协会拇趾跖趾-指间量表、疼痛视觉模拟量表和足踝功能障碍指数进行临床评估。比较治疗前后的评分，分别来自临床记录和最终随访时的临床评估。

结果

在最后的随访中，记录了所有考虑的分数 (p < 0.01) 的改善。整体不满意率为16.1%。两名 (6.4%) 患者因第一射线缩短而抱怨不适，3 名 (9.7%) 患者抱怨持续性跖骨疼痛。有一个 (3.2 %) 复杂区域疼痛综合症 (CPRS) 病例。没有翻修手术、感染或其他不良事件的报告。结论：使用牛胶原膜的关节置换术是高级 HR 的可靠解决方案，在超过 80% 的患者中具有超过 10 年的持久效果。