Prisma Health, Department of Orthopedic Surgery, Columbia, SC, USA.
Foot Ankle Int. 2024 Apr;45(4):406-411. doi: 10.1177/10711007241227174. Epub 2024 Feb 8.
Metatarsalgia is a common diagnosis for patients with forefoot pain. Many have proposed metatarsal fat pad atrophy is a cause of metatarsalgia and therefore have suggested fat grafting instead of distal metatarsal osteotomies to treat metatarsalgia. For fat grafting to be a viable treatment, fat pad atrophy should correlate with metatarsalgia. This study looked to determine the relationship between metatarsal fat pad thickness and metatarsalgia and the correlation between metatarsal fat pad thickness and patient-reported outcomes.
We conducted a retrospective review of patients with metatarsalgia and those with foot or ankle osteoarthritis who had a nonweightbearing MRI performed between February 1, 2021, and March 1, 2023. Data collected included demographics, PROMIS scores, metatarsal fat pad thickness in the second and third rays of the affected foot, and thinnest area on coronal section, measured on MRI. Student test was used to compare continuous variables, whereas the χ test was used to compare categorical variables. Multivariable linear regression models were used to control for potential confounding factors.
A total of 112 patients were included in this study. Patients with metatarsalgia were significantly more likely to have a lower body mass index (29.3 vs 32.0, .03) than patients with osteoarthritis, but this finding was not present when controlling for confounding variables. We found no significant difference in fat pad thickness between patients with metatarsalgia vs patients with foot or ankle osteoarthritis ( .43). We found no correlation between metatarsal fat pad thickness and pain interference ( .59), physical function ( .64), or mobility ( .94) PROMIS scores.
In this retrospective comparative study of a relatively small cohort we found no significant difference in metatarsal fat pad thickness for patients with metatarsalgia vs patients with foot and ankle osteoarthritis based on nonweightbearing MRI, and no association between metatarsal fat pad thickness and patient-reported outcomes.
Level III, case control study.
跖痛症是前足疼痛患者的常见诊断。许多人认为跖骨头下脂肪垫萎缩是跖痛症的原因，因此建议进行脂肪移植而不是跖骨远端截骨术来治疗跖痛症。为了使脂肪移植成为一种可行的治疗方法，脂肪垫萎缩应该与跖痛症相关。本研究旨在确定跖骨头下脂肪垫厚度与跖痛症之间的关系，以及跖骨头下脂肪垫厚度与患者报告的结果之间的相关性。
我们对 2021 年 2 月 1 日至 2023 年 3 月 1 日期间接受非负重 MRI 检查的跖痛症患者和足部或踝关节骨关节炎患者进行了回顾性研究。收集的数据包括人口统计学资料、PROMIS 评分、受影响足部第二和第三跖骨的跖骨头下脂肪垫厚度以及冠状位上最薄的区域，MRI 测量。使用 Student 检验比较连续变量，使用 χ 检验比较分类变量。使用多变量线性回归模型控制潜在的混杂因素。
本研究共纳入 112 例患者。与骨关节炎患者相比，跖痛症患者的体重指数明显更低（29.3 比 32.0，P <.03），但在控制混杂因素后，这种差异并不存在。我们发现跖痛症患者与足部或踝关节骨关节炎患者的脂肪垫厚度没有显著差异（P =.43）。我们没有发现跖骨头下脂肪垫厚度与疼痛干扰（P =.59）、身体功能（P =.64）或活动能力（P =.94）PROMIS 评分之间存在相关性。
在这项基于非负重 MRI 的回顾性小队列病例对照研究中，我们没有发现跖痛症患者与足部和踝关节骨关节炎患者的跖骨头下脂肪垫厚度存在显著差异，也没有发现跖骨头下脂肪垫厚度与患者报告的结果之间存在关联。
III 级，病例对照研究。
