Angthong, Chayanin, Rajbhandari, Prasit and Handoyo, Henry Ricardo (2021) Minimally invasive surgery versus an arthroscopic procedure for the first metatarsophalangeal arthrodesis: A comparative study of the effectiveness and safety profile. European Journal of Orthopaedic Surgery and Traumatology, 31 (3). pp. 417-501. ISSN pISSN: 16338065, eISSN: 14321068
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Abstract
Introduction: Firs metatarsophalangeali(MTP) arthrodesis is a common procedure for treating degeneration in the MTP joint.Open arthrodesis is a conventional procedure that provides acceptable results but is more invasive than minimally invasive or arthroscopic arthrodesis. However, little is known about the diferent out comes between minimally invasive surgeryi(MIS) and arthroscopic surgery(AS) for MTP arthrodesis. This study was perfor med to compare the outcomes of the first MTP joint preparation for arthrodes siregarding the efectiveness of articular surface preparation and safety between MIS and the arthroscopic procedure in cadaveric specimens. Methodsi: Sixteen cadaveric feet were collected in this study from eight cadavers. The potential exclusion criteria were sign ificantly decomposed or deformed joint. All feet were randomly allocated into two groups, eight feet for the MIS (under fluoroscopic control) group and eight feet for the arthroscopic group. One foot in the AS group was excluded because the position of an arthroscopic portal was incorrect. All feet were operated on by four fellowship-trained foot and ankle orthopedic surgeons who also had prior clinical experience with the arthroscopic and minimal invasi ve procedure. Following a complete procedure in each specimen, all feet were dissected and the areas of joint preparation on the metatarsal and phalangeal sides were recordedivia photography and the ImageJ program. Injury to the adjacent structure was noted in each specimen. All data were analyzed via the IBM SPSS program version 22 and GraphPad to compare the out comes between the two groups. Results: The average age of the cadavers was 68.6i±i12.3 years. The average areas of joint preparation on the metatarsali and phalangeal sides were 136.97 and 99.08 mm 2, respectively. The average areas of joint preparation on the metatarsal sides were 154.26 and 117.21 mm 2 in thei\ MIS and arthroscopic groups, respectively (pivalue=i0.353). The average areas of joint preparation on the phalangeal sides were 82.46 and 118.08 mm 2 in the MIS and arthroscopic groups, respectively (pivalue= 0.151). Regarding the ratio of prepared area/mean estimated fusion contact area, there was no sign lcant diference of airatio on metatarsalis de with pivalue as 0.285. However, aihigher level of ratio on phalangealis deiwas found in the arthroscopic group with pivalue as 0.085. For the safety prolles, the rate of adjacent injury was in signilcantly higher in the MIS group (37.5%) than the arthroscopic group (0%) (pivalue =0.20). All injuries were found at the extensor hallucis longus tendon. Conclusions: There were no significant diferences of the efectiveness of articular surface preparation between the MIS and arthroscopic groups. However, the arthroscopic procedure seemed to provide higher rate of prepared surface area on phalangeal side and be safer to the adjacent structures than MIS for this arthrodesis.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Minimally invasive surgery· Arthroscopy· arthrodesis· First metatarsophalangeal joint |
| Subjects: | Medicine |
| Divisions: | Journal Publication |
| Depositing User: | F.X. Hadi |
| Date Deposited: | 28 Oct 2025 02:48 |
| Last Modified: | 28 Oct 2025 02:48 |
| URI: | https://repositori.ukwms.ac.id/id/eprint/44630 |
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