Department of Orthopaedics, Duke University Hospital, Durham, NC, USA.
Duke University School of Medicine, 2927 40 Duke Medicine Circle 124 Davison Building, Durham, NC 27710, USA.
Foot Ankle Clin. 2024 Sep;29(3):541-556. doi: 10.1016/j.fcl.2023.12.009. Epub 2024 Feb 1.
This article describes the etiology, clinical presentation, surgical management, and outcomes for treatment of the failed first metatarsophalangeal (MTP) joint arthroplasty. Failure following implant arthroplasty typically creates large osseous deficits and surgical management can be difficult. Salvage arthrodesis provides reliable joint stability while maintaining hallux length. Outcomes following conversion of a failed MTP joint arthroplasty to MTP joint arthrodesis have demonstrated consistent pain relief and high satisfaction: however, high rates of complication and nonunion have been reported. Bone graft may be necessary to fill large voids in the joint. Other revision options for failed arthroplasty have been described, but outcomes remain inconsistent and varied. Ultimately, conversion to MTP joint arthrodesis is the recommended intervention for treatment of the failed MTP arthroplasty implant, providing sufficient stability and pain relief.
本文描述了初次跖趾关节（MTP）关节置换失败的病因、临床表现、手术治疗和结果。关节置换术后失败通常会导致大量骨缺损，手术治疗可能较为困难。融合术可提供可靠的关节稳定性，同时保持拇趾长度。将 MTP 关节置换失败转换为 MTP 关节融合术的结果已证明可持续缓解疼痛和提高满意度：然而，已报道了较高的并发症和不愈合率。可能需要植骨来填补关节内的大空洞。已经描述了其他用于治疗失败的关节置换的翻修选择，但结果仍然不一致且有所不同。最终，转换为 MTP 关节融合术是治疗 MTP 关节置换失败的推荐干预措施，可提供足够的稳定性和缓解疼痛。
