Deheer Patrick A
1325 N. National Road, Columbus, IN 47201, USA.
Clin Podiatr Med Surg. 2006 Oct;23(4):709-23, vi. doi: 10.1016/j.cpm.2006.08.001.
This article argues the practice of first metatarsal phalangeal joint (MPJ) implant arthroplasty. Intermediate and long-term studies raise concerns about implant failure and longevity. Other causes for concern are silicone-induced synovitis and lymphadenopathy. This article presents evidence against the practice of first metatarsal phalangeal implant arthroplasty. Intermediate and long-term studies raise concerns about implant failure and longevity. Furthermore, the lack of any significant long-term results and the documented metallic breakdown from two-piece metallic implants make their use in hallux rigidus questionable. Meanwhile, a comparative study shows the superiority of arthrodesis to implant arthroplasty. Also, alternatives to joint-destructive procedures are emerging. These include arthrodiastasis and the osteochondral autograft transfer procedure. This evidence proves that implant arthroplasty is not the best treatment for patients with hallux rigidus or other first-MPJ pathology.
本文探讨了第一跖趾关节（MPJ）植入物关节成形术的应用情况。中期和长期研究引发了对植入物失败和使用寿命的担忧。其他令人担忧的原因包括硅酮诱导的滑膜炎和淋巴结病。本文提供了反对第一跖趾关节植入物关节成形术应用的证据。中期和长期研究引发了对植入物失败和使用寿命的担忧。此外，缺乏任何显著的长期结果以及两件式金属植入物记录在案的金属分解情况，使得它们在僵硬性拇趾的应用受到质疑。同时，一项比较研究表明关节融合术优于植入物关节成形术。此外，关节破坏性手术的替代方法正在出现。这些方法包括关节扩张术和自体骨软骨移植手术。这些证据证明，植入物关节成形术并非僵硬性拇趾或其他第一跖趾关节病变患者的最佳治疗方法。
