1 Department of Foot and Ankle Surgery, Hospital for Special Surgery, New York, NY, USA.
2 Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA.
Foot Ankle Int. 2019 Jul;40(7):745-752. doi: 10.1177/1071100719842799. Epub 2019 Apr 16.
Arthrodesis of the first metatarsophalangeal (MTP) joint has been shown to be effective in alleviating pain and correcting deformity in hallux rigidus. However, outcomes in specific sports and physical activities remain unclear. The aim of this study was to assess sports and physical activities in young patients following first MTP joint arthrodesis and to compare these results with clinical outcomes.
Patients between ages 18 and 55 years who underwent MTP arthrodesis were identified by review of a prospective registry. Fifty of 73 eligible patients (68%) were reached for follow-up at a mean of 5.1 (range, 2.2-10.2) years with a mean age at surgery of 49.7 (range, 23-55) years. Physical activity was evaluated with a previously developed sports-specific, patient-administered questionnaire. Clinical outcomes were evaluated with the Foot and Ankle Outcome Score (FAOS).
Patients participated in 22 different sports and physical activities. The most common were walking, biking, weightlifting, swimming, running, and golf. Compared to preoperatively, patients rated 27.4% of activities as less difficult, 51.2% as the same, and 21.4% as more difficult. Patients returned to 44.6% of preoperative physical activities in less than 6 months and reached their maximal level of participation in 88.6% of physical activities. Ninety-six percent of patients (48/50) were satisfied with the procedure regarding return to sports and physical activities. Improvements in the FAOS Symptoms subscore were associated with increased postoperative running and walking duration, and improvements in FAOS Pain subscores were associated with greater patient satisfaction.
Patients were able to participate in a wide variety of sports and physical activities postoperatively. Some patients reported increased difficulty, but were nonetheless satisfied with the procedure regarding physical activity participation. These findings suggest that first MTP joint arthrodesis is a reasonable option in young, active patients, and may be used to guide postoperative expectations.
Level IV, retrospective case series.
第一跖趾关节（MTP）融合术已被证实可有效缓解僵硬拇囊炎的疼痛并矫正畸形。然而，其在特定运动和体力活动中的效果尚不清楚。本研究旨在评估年轻患者 MTP 关节融合术后的运动和体力活动情况，并将这些结果与临床结果进行比较。
通过回顾前瞻性登记处，确定了年龄在 18 至 55 岁之间接受 MTP 关节融合术的患者。73 名符合条件的患者中有 50 名（68%）在平均 5.1 年（范围，2.2-10.2 年）时接受了随访，手术时的平均年龄为 49.7 岁（范围，23-55 岁）。通过之前开发的运动特异性、患者管理问卷评估体力活动。使用足部和踝关节结局评分（FAOS）评估临床结果。
患者参与了 22 种不同的运动和体力活动。最常见的是步行、骑自行车、举重、游泳、跑步和打高尔夫。与术前相比，患者将 27.4%的活动评为更轻松，51.2%评为相同，21.4%评为更困难。患者在不到 6 个月的时间内恢复了 44.6%的术前体力活动，并在 88.6%的体力活动中达到了最大参与水平。96%的患者（48/50）对手术恢复运动和体力活动感到满意。FAOS 症状子评分的改善与术后跑步和步行时间的增加有关，FAOS 疼痛子评分的改善与患者满意度的提高有关。
患者术后能够参与各种运动和体力活动。一些患者报告活动难度增加，但对手术参与体力活动的结果仍感到满意。这些发现表明，对于年轻、活跃的患者，第一跖趾关节融合术是一种合理的选择，并且可以用来指导术后预期。
IV 级，回顾性病例系列。
