Barwick Thomas W, Talkhani I S
Specialist Registrar in Trauma and Orthopaedics, James Cook University Hospital, Middlesbrough, England, UK.
Foot (Edinb). 2008 Sep;18(3):150-5. doi: 10.1016/j.foot.2008.03.006. Epub 2008 May 19.
Evidence regarding the efficacy of the MOJE ceramic press fit total joint replacement for the first metatarso-phalangeal joint (MTPJ) is lacking.
Our aim was to assess the clinical outcome for the MOJE arthroplasty in a single surgeon series using objective and subjective assessment tools.
A retrospective outcome study of 24 implants was performed in 22 patients undergoing first MTPJ replacement for osteoarthritis from 2004 to 2006. Each patient underwent clinical assessment using the American Orthopaedic Foot and Ankle Score (AOFAS) for the hallux and a patient outcome satisfaction questionnaire. All pre- and post-operative radiographs were reviewed.
Average follow-up was 26 months with a median AOFAS score of 80 out of a maximum 100. The revision rate at 3 years was 12.5%. Only 63% of patients were 'very satisfied' with the overall outcome from the procedure. AOFAS for the hallux correlated strongly with patient satisfaction. Radiographical mal-alignment in four patients was significantly associated with lower AOFAS (p=0.01).
This implant offers less reliable outcomes than the 'gold standard' arthrodesis and one would advise caution regarding its use for osteoarthritis of the first MTPJ.
