Base de dados : MEDLINE
Pesquisa : C05.330.488.310 [Categoria DeCS]
Referências encontradas : 303 [refinar]
Mostrando: 1 .. 10   no formato [Detalhado]

página 1 de 31 ir para página                         

  1 / 303 MEDLINE  
              next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28449701
[Au] Autor:Kuyucu E; Mutlu H; Mutlu S; Gülenç B; Erdil M
[Ad] Endereço:Orthopedics and Traumatology, Istanbul Medipol University, Istanbul, Turkey. ersinkuyucu@yahoo.com.tr.
[Ti] Título:Arthroscopic treatment of focal osteochondral lesions of the first metatarsophalangeal joint.
[So] Source:J Orthop Surg Res;12(1):68, 2017 Apr 27.
[Is] ISSN:1749-799X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Although arthroscopic surgical treatment of the first metatarsophalangeal (MTP) joint involves painful sesamoid excision, synovectomy, debridement, and partial cheilectomy, no gold standard treatment technique has been defined in the literature for hallux rigidus and focal osteochondral lesions. This study aimed to assess the arthroscopic treatment for early grade focal osteochondral lesions of the first MTP joint and to determine the impact of arthroscopic microhole drill surgery on foot function and activities of daily living in a group of patients who failed conservative treatment. METHODS: This prospective study included 14 patients with hallux rigidus and focal osteochondral lesions of the first MTP joint who underwent surgery in 2014 and were followed on a regular basis thereafter. RESULTS: The patients had mean preoperative VPS (visual pain score) and AOFAS (American Orthopedic Foot and ankle Society)-Hallux scores of 8.14 ± 0.86 SD and 48.64 ± 4.27, respectively; the corresponding postoperative values of both scores were 1.86 ± 0.66 SD and 87.00 ± 3.70. Both VPS and AOFAS-Hallux scores changed significantly. DISCUSSION: In this prospective study, we explored the impact of arthroscopic microhole drill surgery on foot function and activities of daily living in patients with focal osteochondral lesions of the first MTP joint. Our results showed significant improvements in VPS and AOFAS scores with this treatment. CONCLUSIONS: An arthroscopic microhole drill technique can be used with impressive functional scores and without any complications in patients who failed conservative therapy for hallux rigidus with focal chondral injury.
[Mh] Termos MeSH primário: Artroscopia/métodos
Hallux Rigidus/diagnóstico por imagem
Hallux Rigidus/cirurgia
Articulação Metatarsofalângica/diagnóstico por imagem
Articulação Metatarsofalângica/cirurgia
[Mh] Termos MeSH secundário: Adulto
Estudos de Coortes
Feminino
Seres Humanos
Masculino
Meia-Idade
Estudos Prospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1186/s13018-017-0562-7


  2 / 303 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28367694
[Au] Autor:Stone OD; Ray R; Thomson CE; Gibson JN
[Ad] Endereço:1 Edinburgh Royal Infirmary, Edinburgh, United Kingdom.
[Ti] Título:Long-Term Follow-up of Arthrodesis vs Total Joint Arthroplasty for Hallux Rigidus.
[So] Source:Foot Ankle Int;38(4):375-380, 2017 Apr.
[Is] ISSN:1944-7876
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The optimal operative management of hallux rigidus is still a matter for debate among surgeons. Despite arthrodesis widely considered to be the gold standard treatment, many surgeons advocate arthroplasty as a suitable alternative. There are, however, few long-term or high-quality studies evaluating these modalities. We present the 15-year follow-up of a randomized controlled trial. METHODS: This data is the follow-up to the original study published in 2005. In the original study, 63 patients (77 toes) were recruited to and randomized to have either metatarsophalangeal joint (MTPJ) arthrodesis or arthroplasty. The primary outcome measure was a decrease in pain on a visual analog scale (VAS) at 24 months. In the present study, data were available for all surviving patients (52 patients, 66 toes). Data were collected in the form of satisfaction scores, VAS for pain, the VAS foot and ankle and survivorship data. RESULTS: The results of the original study demonstrated that pain relief was greater following arthrodesis at 2 years. At 15 years, patients with an arthrodesis experienced less pain and were more satisfied compared to those with an arthroplasty. No functional differences were seen between these 2 groups. There were more revisions in the arthroplasty group. CONCLUSION: Despite the hope of better function, less pain, and greater satisfaction from MTPJ replacement, this was not found in our patient population. The long-term results of our study showed that arthrodesis outperformed arthroplasty. If an arthroplasty failed, then salvage was likely to be technically difficult, with significant potential for complications. LEVEL OF EVIDENCE: Level I, randomized controlled trial.
[Mh] Termos MeSH primário: Artrodese/métodos
Artroplastia de Substituição/métodos
Hallux Rigidus/cirurgia
Articulação Metatarsofalângica/cirurgia
[Mh] Termos MeSH secundário: Seguimentos
Hallux Rigidus/diagnóstico
Seres Humanos
Estudos Longitudinais
Medição da Dor
Estudos Retrospectivos
Terapia de Salvação
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170913
[Lr] Data última revisão:
170913
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170404
[St] Status:MEDLINE
[do] DOI:10.1177/1071100716682994


  3 / 303 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28259027
[Au] Autor:Maher AJ
[Ad] Endereço:Department of Podiatric Surgery, Nottinghamshire Healthcare NHS Foundation Trust, Park House Health and Social Care Centre, 61 Burton Road, Nottingham, NG4 3DQ, United Kingdom. Electronic address: Anthony.maher@nottshc.nhs.uk.
[Ti] Título:Patient reported outcomes six months following surgical treatment of end stage hallux rigidus in a community based podiatric surgery service.
[So] Source:Foot (Edinb);30:32-37, 2017 Mar.
[Is] ISSN:1532-2963
[Cp] País de publicação:Scotland
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: End stage hallux rigidus can be treated surgically by arthrodesis, excisional arthroplasty and implant arthroplasty. Evaluation of these techniques has focused on clinical indicators such as radiographic, complications and subjective examination. Little attention has been given to health related quality of life and the use of patient reported outcome measures is still infrequent. METHOD: An evaluation was undertaken in a community based podiatric surgery service. utilising the PASCOM-10 online database. Patient reported outcomes were captured on the day of surgery and six months' post operation in the form of the Manchester Oxford Foot Questionnaire (MOXFQ) and the PASCOM PSQ-10 patient satisfaction questionnaire. RESULTS: Between 1st November 2011 and 31st October 2014, there were 157 admissions for treatment of end-stage hallux rigidus; 61 implant arthroplasties, 53 Keller's arthroplasties and 43 arthrodeses. The age range was 45-89, 72% female. MOXFQ scores improved across all domains for all procedures, the score change exceeded the minimal clinically important change threshold of 13 points and large effect sizes were achieved (range 1.10-3.179). Patient satisfaction was good for all procedures with mean PSQ-10 scores of 81.89 for arthrodesis; 82.36 for implants and 81.89 for Keller's. Few serious complications were encountered though the overall incidence of complications was high for the implant group. CONCLUSION: This evaluation found all three procedures are clinically effective with high levels of patient satisfaction and improved quality of life. Although the implant arthroplasty is associated with a higher incidence of complications, this is not reflected in the outcomes achieved.
[Mh] Termos MeSH primário: Hallux Rigidus/cirurgia
Medidas de Resultados Relatados pelo Paciente
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Artrodese
Artroplastia de Substituição
Feminino
Seres Humanos
Masculino
Meia-Idade
Satisfação do Paciente
Qualidade de Vida
Estudos Retrospectivos
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171107
[Lr] Data última revisão:
171107
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170305
[St] Status:MEDLINE


  4 / 303 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28159038
[Au] Autor:Voegeli AV; Marcellini L; Sodano L; Perice RV
[Ad] Endereço:Surgery service COT Clinica Tres Torres Barcelona, Spain. Electronic address: 9393avv@gmail.com.
[Ti] Título:Clinical and radiological outcomes after distal oblique osteotomy for the treatment of stage II hallux rigidus: Mid-term results.
[So] Source:Foot Ankle Surg;23(1):21-26, 2017 Mar.
[Is] ISSN:1460-9584
[Cp] País de publicação:France
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The aim of this retrospective study was to evaluate the mid-term outcomes of the distal oblique osteotomy in the correction of stage II hallux rigidus. METHODS: We evaluated 31 patients (32ft.) treated from March 2009 to April 2013 for hallux rigidus. The subjective evaluation was based on AOFAS score and self-evaluation of patient satisfaction. Radiographic analysis included: HVA, IMA, first metatarsophalangeal joint space, declination and shortening of first metatarsal. RESULTS: The mean follow-up was 39.4±15.5 months (range, 24-73). The mean final AOFAS score was 89.1±6.5 from a preoperative score of 41.5±12 (p<0.001). Pain was totally absent in 71.9% of cases and mild occasionally present in 28.1%. The complication rate was of 6.2% (two cases). CONCLUSIONS: These results demonstrate that the first metatarsal distal oblique osteotomy is an effective surgical treatment for stage II hallux rigidus with decrease of daily pain, high patient satisfaction and improved the range of motion.
[Mh] Termos MeSH primário: Hallux Rigidus/cirurgia
Ossos do Metatarso/cirurgia
Osteotomia
[Mh] Termos MeSH secundário: Adulto
Idoso
Feminino
Hallux Rigidus/diagnóstico por imagem
Seres Humanos
Masculino
Meia-Idade
Satisfação do Paciente
Radiografia
Amplitude de Movimento Articular
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171106
[Lr] Data última revisão:
171106
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170205
[St] Status:MEDLINE


  5 / 303 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28095703
[Au] Autor:Cho BK; Park KJ; Park JK; SooHoo NF
[Ad] Endereço:1 Department of Orthopaedic Surgery, College of Medicine, Chungbuk National University, Cheongju, Korea.
[Ti] Título:Outcomes of the Distal Metatarsal Dorsiflexion Osteotomy for Advanced Hallux Rigidus.
[So] Source:Foot Ankle Int;38(5):541-550, 2017 May.
[Is] ISSN:1944-7876
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Hallux rigidus can be treated using several different methods and the best treatment option depends on the severity of degenerative changes of the metatarsophalangeal (MTP) joint. However, the ideal operative option for advanced hallux rigidus remains debatable. This prospective study was performed to evaluate the intermediate-term clinical outcomes of distal metatarsal osteotomy used as a joint-preserving method for the treatment of advanced hallux rigidus. METHODS: Forty-two cases (39 patients) were followed for more than 3 years after distal metatarsal dorsiflexion osteotomy for advanced hallux rigidus of grade III-IV. Clinical evaluations included the American Orthopaedic Foot & Ankle Society (AOFAS) scores, Foot and Ankle Ability Measure (FAAM) scores, and patient subjective satisfaction scores. Range of motion (ROM) of great toe, complications, reoperation rates, width of the MTP joint space, and times to union were evaluated. RESULTS: Mean AOFAS hallux and mean FAAM scores significantly improved from 56.4 and 61.2 points preoperatively to 87.6 and 88.7 points at final follow-up, respectively ( P < .001). Grade III and IV groups had significantly different AOFAS and FAAM scores at final follow-up. Mean dorsiflexion of great toe significantly improved from 14.8° preoperatively to 35.5° at final follow-up ( P < .001). Mean patient satisfaction score at final follow-up was 92.8 points. There were 4 cases (9.5%) of subsequent fusion and 2 cases (4.8%) of transfer metatarsalgia. CONCLUSIONS: Distal metatarsal dorsiflexion osteotomy using bio-compression screws appears to be an effective operative option for grade III advanced hallux rigidus with viable cartilage on >50% of the first metatarsal articular surface, as it restored joint motion, provided reliable pain relief, and did not require implant removal. However, based on the unsatisfactory clinical results and the high rate of reoperation observed, the authors cannot recommend this operative method for the treatment of end-stage (grade IV) hallux rigidus. LEVEL OF EVIDENCE: Level IV, prospective case series.
[Mh] Termos MeSH primário: Hallux Rigidus/cirurgia
Hálux/cirurgia
Ossos do Metatarso/cirurgia
Articulação Metatarsofalângica/cirurgia
Osteotomia/métodos
[Mh] Termos MeSH secundário: Hálux/fisiologia
Hallux Rigidus/fisiopatologia
Seres Humanos
Amplitude de Movimento Articular
Reoperação
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170119
[St] Status:MEDLINE
[do] DOI:10.1177/1071100716688177


  6 / 303 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28038564
[Au] Autor:Baumhauer J
[Ti] Título:Response to "Letter Regarding: Prospective, Randomized, Multi-centered Clinical Trial Assessing Safety and Efficacy of a Synthetic Cartilage Implant Versus First Metatarsophalangeal Arthrodesis in Advanced Hallux Rigidus".
[So] Source:Foot Ankle Int;38(1):108-110, 2017 01.
[Is] ISSN:1944-7876
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Artrodese
Hallux Rigidus/cirurgia
[Mh] Termos MeSH secundário: Cartilagem
Seres Humanos
Articulação Metatarsofalângica/cirurgia
Estudos Prospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; COMMENT
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170912
[Lr] Data última revisão:
170912
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170101
[St] Status:MEDLINE
[do] DOI:10.1177/1071100716681632


  7 / 303 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28038562
[Au] Autor:Kane L
[Ti] Título:Letter Regarding: Prospective, Randomized, Multi-centered Clinical Trial Assessing Safety and Efficacy of a Synthetic Cartilage Implant Versus First Metatarsophalangeal Arthrodesis in Advanced Hallux Rigidus.
[So] Source:Foot Ankle Int;38(1):107, 2017 01.
[Is] ISSN:1944-7876
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Artrodese
Hallux Rigidus/cirurgia
[Mh] Termos MeSH secundário: Cartilagem
Seres Humanos
Articulação Metatarsofalângica/cirurgia
Estudos Prospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; COMMENT
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170912
[Lr] Data última revisão:
170912
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170101
[St] Status:MEDLINE
[do] DOI:10.1177/1071100716681631


  8 / 303 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:27909032
[Au] Autor:Daniels TR; Younger AS; Penner MJ; Wing KJ; Miniaci-Coxhead SL; Pinsker E; Glazebrook M
[Ad] Endereço:1 Division of Orthopaedic Surgery, St. Michael's Hospital and University of Toronto, Toronto, Ontario, Canada.
[Ti] Título:Midterm Outcomes of Polyvinyl Alcohol Hydrogel Hemiarthroplasty of the First Metatarsophalangeal Joint in Advanced Hallux Rigidus.
[So] Source:Foot Ankle Int;38(3):243-247, 2017 Mar.
[Is] ISSN:1944-7876
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Hallux rigidus is the most common arthritic condition of the foot. A randomized clinical trial of first metatarsophalangeal (MTP) joint hemiarthroplasty with a polyvinyl alcohol (PVA) hydrogel implant (Cartiva) demonstrated pain relief and functional outcomes equivalent to first MTP arthrodesis at 2 years postoperation, with no cases of implant fragmentation, wear, or bone loss. We prospectively determined 5-year outcomes of first MTP hemiarthroplasty with the PVA hydrogel implant. METHODS: Patients who underwent first PVA hydrogel MTP hemiarthroplasty in the previously reported trial were evaluated at 5 years postoperatively. Patients underwent physical examination and radiographic evaluation and completed a pain VAS, the Short-Form-36 (SF-36), and the Foot and Ankle Ability Measure (FAAM) sports subscale and activities of daily living (ADL) subscale. At the time of this study, 29 patients had reached 5 years' follow-up. Two were lost to follow-up, leaving 27 patients with mean age 56.1 (range, 40.1-71.9) years. Mean follow-up was 5.4 (range, 4.9-6.4) years. RESULTS: Postoperative active MTP natural joint dorsiflexion and peak MTP dorsiflexion were mean 18.2 (range, 10.0-30.0) and 29.7 (range, 10.0-45.0) degrees, respectively. Pain VAS, SF-36 PCS, FAAM ADL, and FAAM Sports scores demonstrated clinically and statistically significant improvements. Radiographically, no patient demonstrated changes in implant position, implant loosening or subsidence, or implant wear. One implant was removed because of persistent pain and converted to fusion 2 years postoperation. CONCLUSION: Five years following first MTP hemiarthroplasty with a PVA hydrogel implant, functional outcomes improved significantly, pain was reduced significantly, and the implant demonstrated excellent survivorship. LEVEL OF EVIDENCE: Level IV, prospective case series.
[Mh] Termos MeSH primário: Artroplastia de Substituição/métodos
Hallux Rigidus/cirurgia
Hemiartroplastia/métodos
Articulação Metatarsofalângica/cirurgia
Álcool de Polivinil/química
[Mh] Termos MeSH secundário: Seres Humanos
Avaliação de Resultados (Cuidados de Saúde)
Medição da Dor
Satisfação do Paciente
Estudos Prospectivos
Amplitude de Movimento Articular
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (polyvinyl alcohol hydrogel); 9002-89-5 (Polyvinyl Alcohol)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170919
[Lr] Data última revisão:
170919
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161203
[St] Status:MEDLINE
[do] DOI:10.1177/1071100716679979


  9 / 303 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:27866887
[Au] Autor:Wanivenhaus F; Espinosa N; Tscholl PM; Krause F; Wirth SH
[Ad] Endereço:Surgeon, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zürich, Switzerland. Electronic address: florian@wanivenhaus.at.
[Ti] Título:Quality of Early Union After First Metatarsophalangeal Joint Arthrodesis.
[So] Source:J Foot Ankle Surg;56(1):50-53, 2017 Jan - Feb.
[Is] ISSN:1542-2224
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The aim of the present retrospective cohort study was to assess the quality of union and the clinical outcomes in patients who had undergone first metatarsophalangeal joint (MTPJ) fusion using a dorsal plate and plantar lag screw. From March 2011 to December 2012, the clinical and radiographic data of 39 patients (41 feet) who had undergone first MTPJ fusion using a compressive locking plate were retrospectively reviewed. All patients had undergone postoperative computed tomography at 6 weeks postoperatively to assess union. The average metatarsophalangeal angles improved from 23° ± 16° preoperatively to 14° ± 5° postoperatively. The dorsiflexion of the hallux at the preoperative assessment averaged 17° ± 11° and 23° ± 5° postoperatively. At 6 weeks postoperatively, the computed tomography scans demonstrated 3 complete fusions (7.3 %) and 38 partial unions (92.7%). Also at 6 weeks, the mean ± standard deviation joint bridging was 54% ± 14.6%. The forefoot American Orthopaedic Foot and Ankle Society scale score had improved significantly from 50 ± 13 preoperatively to 80 ± 7 at >1 year of follow-up (p = .001). Hardware removal was performed in 8 cases because of pain in 7 and infection in 1. Revision arthrodesis was required in 2 cases because of nonunion. At 6 weeks postoperatively, partial bony joint bridging could be observed in most cases after arthrodesis of the first MTPJ with the dorsal fusion plate.
[Mh] Termos MeSH primário: Artrodese/métodos
Hallux Rigidus/cirurgia
Hallux Valgus/cirurgia
Articulação Metatarsofalângica/cirurgia
Amplitude de Movimento Articular/fisiologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Artrodese/instrumentação
Placas Ósseas
Parafusos Ósseos
Estudos de Coortes
Bases de Dados Factuais
Feminino
Seguimentos
Hallux Rigidus/diagnóstico por imagem
Hallux Valgus/diagnóstico por imagem
Seres Humanos
Masculino
Articulação Metatarsofalângica/diagnóstico por imagem
Meia-Idade
Medição da Dor
Controle de Qualidade
Radiografia/métodos
Estudos Retrospectivos
Estatísticas não Paramétricas
Resultado do Tratamento
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170807
[Lr] Data última revisão:
170807
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161122
[St] Status:MEDLINE


  10 / 303 MEDLINE  
              first record previous record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:27846395
[Au] Autor:Nüesch C; Mündermann A; Horisberger M
[Ad] Endereço:University of Basel, University Hospital, Orthopaedics and Traumatology, Switzerland; University of Basel, Department of Biomedical Engineering, Switzerland. Electronic address: corina.nueesch@usb.ch.
[Ti] Título:Mid-term functional outcome of a total arthroplasty of the first metatarsophalangeal joint.
[So] Source:Clin Biomech (Bristol, Avon);41:9-13, 2017 Jan.
[Is] ISSN:1879-1271
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Arthroplasty of the first metatarsophalangeal joint is an alternative treatment option for end-stage hallux rigidus to the current gold standard of arthrodesis. The aim of this study was to investigate the mid-term functional outcome of an anatomically shaped prosthesis for the first metatarsophalangeal joint using pedobarography. METHODS: Ten patients (12 affected feet; age at surgery: 62.1 (SD: 7.2) years) were investigated preoperatively and 52 (SD: 3) months postoperatively using pedobarography (EMED, novel GmbH, Munich, Germany). Two patients were excluded at follow-up because their prosthesis was converted to an arthrodesis. Peak force and plantar pressure under the five metatarsal heads and the hallux were analyzed and correlated with the clinical outcome (pain, American Orthopaedic Foot and Ankle Society forefoot score and radiographic maximum first metatarsophalangeal dorsiflexion). Differences between pre- and postoperative data were analyzed using paired t-tests (alpha=0.05). FINDINGS: Postoperatively, forefoot peak forces under the fourth (+40.9%; P=0.018) and fifth metatarsal (+54.9%; P=0.037) and plantar pressures under the fifth metatarsal (+38.7%; P=0.027) increased significantly, while peak plantar pressures and forces under the hindfoot, medial forefoot and hallux did not change. While maximum passive dorsiflexion was not significantly greater at the 4-year follow-up compared to preoperatively, overall greater passive dorsiflexion was associated with higher first metatarsal peak pressure. INTERPRETATION: Despite of patients reporting less pain, the functional results indicate an altered and potentially non-physiological postoperative gait pattern with a lateralization of the load during walking, especially in patients with limited passive dorsiflexion.
[Mh] Termos MeSH primário: Artroplastia
Hallux Rigidus/fisiopatologia
Hallux Rigidus/cirurgia
Articulação Metatarsofalângica/fisiopatologia
Articulação Metatarsofalângica/cirurgia
[Mh] Termos MeSH secundário: Feminino
Marcha/fisiologia
Hálux/fisiopatologia
Hálux/cirurgia
Seres Humanos
Masculino
Ossos do Metatarso/fisiologia
Meia-Idade
Dor/fisiopatologia
Pressão
Estudos Prospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170922
[Lr] Data última revisão:
170922
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161116
[St] Status:MEDLINE



página 1 de 31 ir para página                         
   


Refinar a pesquisa
  Base de dados : MEDLINE Formulário avançado   

    Pesquisar no campo  
1  
2
3
 
           



Search engine: iAH v2.6 powered by WWWISIS

BIREME/OPAS/OMS - Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde