First metatarsophalangeal joint arthrodesis – Do joint configuration and preparation technique matter?

• Union rates of 1st MTPJ arthrodesis were not affected by joint configuration (flat-on-flat or ball-and-socket).
• The technique used to prepare the joint surfaces did not statistically influence the union rates of 1st MTPJ arthrodesis.
• There was a 95% satisfaction rate with 1st MTPJ arthrodesis but male patients were less satisfied.

BackgroundThe purpose of this study was to investigate the influence of joint configuration and preparation on first metatarsophalangeal (MTPJ) union rates.MethodsWe performed a retrospective analysis of first MTPJ arthrodeses undertaken in our institution. Clinical notes, radiographs and postal questionnaires were used to determine outcome.ResultsTwo hundred first MTPJ arthrodeses (172 patients) were included in the analysis (34 male: 138 female; mean age 62 yr). The overall union rate was 93.5%. Union was achieved in 109/118 MTPJs (92.4%) prepared in the flat-on-flat configuration and in 78/82 (95%) prepared in the ball-and-socket configuration (p = 0.438). Higher union rates favoured low-velocity joint preparation [using rongeur only 21/21 (100%), rongeur and burr 26/27 (96.3%) and conical reamer 31/34 (91.2%)] but this did not reach statistical significance (p = 0.317). There was a 95% satisfaction rate with surgery but male patients were less satisfied (p = 0.031).ConclusionUnion rates were not influenced by joint configuration or preparation techniques.