First metatarsophalangeal joint arthrodesis - Do joint configuration and preparation technique matter?

Background: The purpose of this study was to investigate the influence of joint configuration and preparation on first metatarsophalangeal (MTPJ) union rates. Methods: We performed a retrospective analysis of first MTPJ arthrodeses undertaken in our institution. Clinical notes, radiographs and postal questionnaires were used to determine outcome. Results: Two hundred first MTPJ arthrodeses (172 patients) were included in the analysis (34 male: 138 female; mean age 62 yr). The overall union rate was 93.5%. Union was achieved in 109/118 MTPJs (92.4%) prepared in the flat-on-flat configuration and in 78/82 (95%) prepared in the ball-and-socket configuration (p = 0.438). Higher union rates favoured low-velocity joint preparation [using rongeur only 21/21 (100%), rongeur and burr 26/27 (96.3%) and conical reamer 31/34 (91.2%)] but this did not reach statistical significance (p = 0.317). There was a 95% satisfaction rate with surgery but male patients were less satisfied (p = 0.031). Conclusion: Union rates were not influenced by joint configuration or preparation techniques. (C) 2014 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.