Director, Department of Sports Medicine, Palo Alto Medical Foundation, Palo Alto, CA.
Podiatric Physician and Surgeon, Reconstructive Orthopedics, Sewell, NJ.
J Foot Ankle Surg. 2021 Jul-Aug;60(4):845-849. doi: 10.1053/j.jfas.2019.11.011. Epub 2020 Dec 31.
Osteochondral defects, often caused by traumatic injuries, are focal areas of articular damage resulting in joint pain and stiffness ultimately leading to degenerative joint disease. This has not been well studied in the first metatarsal head, but is an often encountered problem in the active population in other joints. In this study, we prospectively evaluated the results of 12 patients who received autogenous bone grafting for repair of osteochondral defects of the first metatarsal head. Clinical outcomes were evaluated by the visual analog scale for pain and the Roles and Maudsley (RM) score. Between the years of 2009 and 2016, 12 patients received treatment for this particular surgical intervention and their outcomes were measured. The patients' average age was 43.5 ± 10.6 years and were followed from 52.3 ± 26.7 months postoperatively. Average return to activity was 4.7 ± 1.1 months. The average preoperative RM score was 4.0 ± 0.0 and postoperative RM score was 1.4 ± 0.7 (p = .0001). The encouraging outcomes of this study suggest that autogenous bone grafting for osteochondral defects of the first metatarsal head is an effective treatment to help restore the function of the first metatarsophalangeal joint.
骨软骨缺损，常由创伤引起，是关节损伤的局灶性区域，导致关节疼痛和僵硬，最终导致退行性关节病。在第一跖骨头中，这方面的研究还不够充分，但在其他关节的活跃人群中，这是一个常见的问题。在这项研究中，我们前瞻性评估了 12 例接受自体骨移植修复第一跖骨头骨软骨缺损患者的结果。临床结果通过视觉模拟评分法（VAS）评估疼痛，通过 Roles 和 Maudsley（RM）评分评估功能。2009 年至 2016 年间，有 12 例患者接受了这种特殊手术干预，对其结果进行了测量。患者的平均年龄为 43.5 ± 10.6 岁，术后随访 52.3 ± 26.7 个月。平均恢复活动时间为 4.7 ± 1.1 个月。术前 RM 评分为 4.0 ± 0.0，术后 RM 评分为 1.4 ± 0.7（p =.0001）。这项研究的结果令人鼓舞，表明自体骨移植治疗第一跖骨头骨软骨缺损是一种有效的治疗方法，有助于恢复第一跖趾关节的功能。
