Niehaus Richard, Hodel Sandro, Eid Karim, Bensler Susanne, Lenz Christopher G
Department of Orthopaedic Surgery, Kantonsspital Baden, Baden, Switzerland.
Department of Radiology, Kantonsspital Baden, Baden, Switzerland.
J Foot Ankle Surg. 2022 Nov-Dec;61(6):1203-1208. doi: 10.1053/j.jfas.2022.02.003. Epub 2022 Feb 15.
The modified "Lapidus" procedure (MLP) describes the arthrodesis of the first tarsometatarsal joint. We investigate if there are detectable changes of the tendon or the function of the muscle and clinical outcome after MLP. We reviewed 22 feet. All patients underwent magnetic resonance imaging (MRI) at an average of 27 (range, 12-49) months. Clinical outcome was evaluated using the European Foot and Ankle Society score. Strength was measured and complications were assessed. MRI revealed signs of tendinopathy of the tibialis anterior tendon in 13 feet (59%). The mean total European Foot and Ankle Society score at final follow-up was 17 (range, 6-24) points. The mean postoperative Visual Analog Scale score was 1.4 (range, 0-5). Range of motion and force data were not significantly different to the contralateral side. In conclusion, MRI showed signs of tendinopathy in 59%, which does not seem to affect clinical outcome, but has to be considered when choosing the desired implant and placement. MLP leads to high patient satisfaction rates and significant improvement at midterm follow up.
改良“拉皮德斯”手术（MLP）用于描述第一跖跗关节融合术。我们研究了MLP术后肌腱或肌肉功能是否有可检测到的变化以及临床结果。我们回顾了22只脚。所有患者平均在27（范围12 - 49）个月时接受了磁共振成像（MRI）检查。使用欧洲足踝协会评分评估临床结果。测量肌力并评估并发症。MRI显示13只脚（59%）存在胫前肌腱病迹象。最终随访时欧洲足踝协会总评分平均为17（范围6 - 24）分。术后视觉模拟量表评分平均为1.4（范围0 - 5）。活动范围和力量数据与对侧相比无显著差异。总之，MRI显示59%有肌腱病迹象，这似乎不影响临床结果，但在选择合适的植入物和放置时必须予以考虑。MLP在中期随访时能带来较高的患者满意度和显著改善。
