Our Summary

This research paper discusses a medical procedure called first metatarsophalangeal (MTP) joint fusion. This procedure is used to ease the pain from severe arthritis and to create a stable, flat first toe. The surgery can also correct deformities and fill in larger defects with a graft taken from the patient or a donor. The fusion is usually achieved using screws, staples, or low-profile plates. There are some possible complications including infection, bone death, implant issues, and problems with the bone healing incorrectly or not at all. However, these complications are relatively rare. The paper suggests that this procedure generally has good results, with success rates around 90%.

FAQs

  1. What is the primary goal of first metatarsophalangeal joint fusion?
  2. What complications can arise from first MTP joint fusion?
  3. What is the success rate of first MTP joint fusion according to medium-term results?

Doctor’s Tip

One helpful tip a doctor might tell a patient about joint fusion is to follow post-operative rehabilitation guidelines closely to ensure proper healing and optimal outcomes. This may include physical therapy, specific exercises, and restrictions on weight-bearing activities. It is important to communicate any concerns or difficulties with the healthcare team to address them promptly and prevent potential complications.

Suitable For

Patients who are typically recommended joint fusion include those with end-stage arthritis of the first metatarsophalangeal (MTP) joint, deformities associated with arthritis, and those with greater defects that require interposition autograft or allograft. Patients experiencing pain and instability in the first toe, such as those with hallux rigidus, may also benefit from joint fusion. Complications of joint fusion surgery include infection, osteonecrosis, implant failure, nonunion, and malunion, but overall, the medium-term results of first MTP joint fusion are usually successful with good functional outcomes.

Timeline

Before joint fusion:

  • Patient experiences pain and discomfort in the affected joint
  • Patient may have difficulty walking or performing everyday activities
  • Patient may have tried conservative treatments such as medication, physical therapy, and orthotics without success
  • Patient consults with a orthopedic surgeon who recommends joint fusion as a treatment option

After joint fusion:

  • Patient undergoes surgery to fuse the joint using screws, staples, or plates
  • Patient may experience some pain and discomfort immediately following the surgery
  • Patient undergoes a period of immobilization and physical therapy to aid in the healing process
  • Over time, the joint fuses completely and the patient experiences relief from pain and improved function
  • Patient is able to return to normal activities with a stable, plantigrade toe
  • Patient may experience complications such as infection, implant failure, or nonunion, but these are relatively rare
  • Patient may require follow-up appointments with the surgeon to ensure proper healing and function of the joint

What to Ask Your Doctor

  1. What are the potential risks and complications associated with joint fusion surgery?
  2. How long is the recovery period after joint fusion surgery?
  3. What are the expected outcomes in terms of pain relief and improved function after joint fusion surgery?
  4. Are there any alternative treatments to joint fusion that I should consider?
  5. How long will the fusion of the joint last before needing further treatment?
  6. What is the success rate of joint fusion surgery in patients with my specific condition?
  7. Will I need physical therapy or rehabilitation after joint fusion surgery?
  8. How soon can I return to normal activities and exercise after joint fusion surgery?
  9. Will I need any special accommodations or modifications in my daily routine after joint fusion surgery?
  10. Are there any long-term implications or considerations I should be aware of after undergoing joint fusion surgery?

Reference

Authors: Rammelt S, Panzner I, Mittlmeier T. Journal: Foot Ankle Clin. 2015 Sep;20(3):465-77. doi: 10.1016/j.fcl.2015.04.008. Epub 2015 Jun 10. PMID: 26320560