Orthopaedic Department, Tunbridge Wells Hospital, Pembury, Tunbridge Wells, Kent, UK.
Foot Ankle Int. 2012 Jul;33(7):560-4. doi: 10.3113/FAI.2012.0560.
Among the surgical treatment options for osteoarthritis of the first metatarsophalangeal joint (MTPJ) are a number of different designs of total arthroplasty, including the MOJE, a ceramic press fit arthroplasty. We present a 2- to 8-year followup of 31 procedures.
Thirty-two MOJE arthroplasties were undertaken for painful hallux rigidus in 30 patients (nine male, 21 female) over 6 years (mean age 61.9; range, 37 to 76). At followup patients' symptoms, levels of function and radiographs were scored using SF-36, modified Kitaoka and AOFAS systems. Followup rate was 97%, with mean followup time 58 months (range, 28 to 97).
Mean scores were: Kitaoka 53.8 (15 to 75), AOFAS 61.3/100 (range, 18 to 100), SF-36 physical combined 48.6 (27.6 to 58.7) SF-36 mental score 52.2 (19.5 to 62.2). Sixteen showed radiological evidence of component loosening (either lucency, subsidence or both) and one radiograph revealed component fracture. Eight implants have been revised. In patients who had not undergone subsequent fusion, 15 had less than 36 degrees of movement, nine had 36 to 45 degrees, four were in the 46 to 60 range, and only one had more than 60 degrees. There were no infections.
Although previous studies have suggested favorable initial outcomes with the MOJE prosthesis, all have focused only on the early results. In our series, the reoperation rate of 26% at up to 8 years is worryingly high, especially given that 16 (52%) showed loosening. Although there appears to be a cohort of patients who have satisfactory outcomes with the MOJE, we would suggest the continued use of this implant.
在治疗第一跖趾关节（MTPJ）骨关节炎的手术选择中，有许多不同设计的全关节置换术，包括 MOJE，一种陶瓷压配合关节置换术。我们报告了 31 例手术的 2 至 8 年随访结果。
在 6 年期间（平均年龄 61.9 岁，范围 37 至 76 岁），对 30 名患者（9 名男性，21 名女性）的 32 例 MOJE 关节置换术进行了回顾性分析，这些患者均患有疼痛性拇僵硬症。在随访时，使用 SF-36、改良 Kitaoka 和 AOFAS 系统对患者的症状、功能水平和 X 线片进行评分。随访率为 97%，平均随访时间为 58 个月（范围 28 至 97 个月）。
平均评分如下：Kitaoka 53.8（15 至 75），AOFAS 61.3/100（范围 18 至 100），SF-36 生理综合 48.6（27.6 至 58.7），SF-36 心理评分 52.2（19.5 至 62.2）。16 例 X 线片显示有部件松动（透亮、下沉或两者兼有）的证据，1 例 X 线片显示有部件骨折。有 18 例植入物已被修正。在未行后续融合的患者中，15 例活动度小于 36 度，9 例活动度为 36 至 45 度，4 例活动度为 46 至 60 度，只有 1 例活动度大于 60 度。没有感染。
尽管先前的研究表明 MOJE 假体的初始结果良好，但所有研究都只关注早期结果。在我们的研究中，8 年时的翻修率为 26%，这令人担忧，尤其是因为有 16 例（52%）显示松动。尽管有一部分患者对 MOJE 的结果感到满意，但我们建议继续使用这种植入物。
