Lower pain score seen with revision arthrodesis of synthetic cartilage implant resurfacing
CHICAGO — Revision metatarsophalangeal joint arthrodesis more significantly reduced pain in patients who had a failed index synthetic cartilage implant for the treatment of hallux rigidus, according to data presented here.
“[Metatarsophalangeal joint] MTPJ arthrodesis was found to reduce pain more significantly as a revision procedure for failed index [synthetic cartilage implant] SCI resurfacing. Future prospective studies should be performed,” Aman Chopra, from Georgetown University School of Medicine, said at the American Academy of Orthopaedic Surgeons Annual Meeting.
Using electronic health records from 2016 to 2021, patients with symptomatic late-stage hallux rigidus who were treated with SCI (Cartiva Synthetic Cartilage Implant, Stryker) were studied. Researchers studied 203 SCI resurfacing procedures, which included 23 revisions. All procedures were performed by a single surgeon. They compared preoperative and postoperative range of motion, VAS pain scores and radiographs.
Overall, researchers found 8.2% of index SCI resulted in failure. Revision surgery was performed at an average of 12.1 months after index SCI resurfacing. Mean age was 52.8 years, and mean follow-up was of 22.3 (range, 3-54) months.
Of the 23 patients who had revisions, 12 patients had a SCI replacement and 11 patients had a metatarsophalangeal joint arthrodesis. The SCI replacement included use of bone graft and/or a custom 3D-printed baseplate to prevent implant subsidence to the metatarsal head. Chopra said 16 of the revisions were performed by the same surgeon and seven revisions were performed by a different surgeon.
Researchers found significantly lower postoperative pain VAS pain scores and a significant improvement from preoperative to postoperative pain VAS scores for patients who had revision arthrodesis.
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Chopra A, et al. Paper 38. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 22-26, 2022; Chicago.
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