Division of Foot and Ankle Surgery, Department of Orthopaedic Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania.
Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
Foot Ankle Spec. 2023 Dec;16(6):527-536. doi: 10.1177/19386400211001993. Epub 2021 Mar 26.
There remains no clear consensus on patient satisfaction and functional outcomes following synthetic cartilage implant (SCI) implantation for hallux rigidus. The purpose of this study was to review our experience at a single academic institution using an SCI for treatment of hallux rigidus.
A retrospective review was performed of patients who underwent the SCI procedure for treatment of hallux rigidus between January 2017 and May 2019. Functional outcomes were evaluated using Patient-Reported Outcome Measures Informational System (PROMIS)-10 scores as well as a survey investigating patient satisfaction, self-reported clinical improvement, and changes in sporting ability. Patients were divided into satisfied versus unsatisfied subgroups, and between-group differences in preoperative variables and complications were reviewed. A total of 90 patients (96 implants) were included in this study. The mean follow-up time was 26.4 months.
In all, 81.2% of patients reported that their foot was "much improved" (55.2%) or "improved" (26.0%) since undergoing the SCI procedure, whereas a slightly lower percentage, 74.0%, stated that they were "extremely satisfied" (41.7%) or "satisfied" (32.3%) at final follow-up. Patients were able to tolerate higher impact sporting activities after the procedure, and 75.0% of patients stated they would have the same surgery again. PROMIS-10 T-scores averaged 54.2 points for physical health and 57.4 points for mental health. Only 2.1% of patients required conversion to arthrodesis. Significant differences between the satisfied versus unsatisfied subgroups were found in preoperative corticosteroid injection use (21.1% vs 41.1%, respectively; = .029) and preoperative VAS pain score (8.2 vs 7.1, respectively; = .036).
The SCI procedure can be a viable option for treating hallux rigidus with high satisfaction overall, increased sport activity levels, and a very low revision rate. However, maximizing patient satisfaction may require more careful consideration of preoperative prognosticators and extensive patient counseling to ensure realistic expectations for recovery time and individual outcome.
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对于拇僵硬症患者，使用合成软骨植入物（SCI）治疗后，其患者满意度和功能结果仍没有明确的共识。本研究的目的是回顾我们在一家学术机构使用 SCI 治疗拇僵硬症的经验。
对 2017 年 1 月至 2019 年 5 月期间接受 SCI 手术治疗拇僵硬症的患者进行回顾性研究。使用患者报告的结果测量信息系统（PROMIS）-10 评分以及一项调查来评估功能结果，该调查调查了患者满意度、自我报告的临床改善以及运动能力的变化。将患者分为满意组和不满意组，比较了术前变量和并发症的组间差异。本研究共纳入 90 例患者（96 个植入物）。平均随访时间为 26.4 个月。
总体而言，81.2%的患者报告说，自接受 SCI 手术后，他们的足部“明显改善”（55.2%）或“改善”（26.0%），而略低的百分比（74.0%）表示，他们在最终随访时“非常满意”（41.7%）或“满意”（32.3%）。患者在手术后能够耐受更高冲击力的运动活动，并且 75.0%的患者表示他们会再次接受相同的手术。PROMIS-10 T 评分平均为 54.2 分的身体健康和 57.4 分的心理健康。只有 2.1%的患者需要转换为融合术。在术前皮质类固醇注射使用（分别为 21.1%和 41.1%； =.029）和术前 VAS 疼痛评分（分别为 8.2 和 7.1； =.036）方面，满意组和不满意组之间存在显著差异。
对于拇僵硬症患者，SCI 手术是一种可行的选择，总体满意度高，运动活动水平提高，且翻修率非常低。然而，为了最大限度地提高患者满意度，可能需要更仔细地考虑术前预后因素，并对患者进行广泛的咨询，以确保对康复时间和个人结果有现实的期望。
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