Treatment of Failed Arthrodesis of First Metatarsophalangeal Joint with Tensor Fascia Lata Interposition Arthroplasty: A Case Report

Jaewoo Sim; Yoonsuk Hyun; Junsik Park; Saehyun Kang; Hwanjin Kwon; Gablae Kim

doi:10.14193/jkfas.2017.21.1.39

Journal List > J Korean Foot Ankle Soc > v.21(1) > 1043440

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Sim, Hyun, Park, Kang, Kwon, and Kim: Treatment of Failed Arthrodesis of First Metatarsophalangeal Joint with Tensor Fascia Lata Interposition Arthroplasty: A Case Report

Case Report

Journal of Korean Foot and Ankle Society 2017; 21(1): 39-42.

Published online: 15 March 2017

DOI: https://doi.org/10.14193/jkfas.2017.21.1.39

Treatment of Failed Arthrodesis of First Metatarsophalangeal Joint with Tensor Fascia Lata Interposition Arthroplasty: A Case Report

Jaewoo Sim^*, Yoonsuk Hyun, Junsik Park, Saehyun Kang, Hwanjin Kwon, Gablae Kim

Department of Orthopaedic Surgery, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.

^*Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Corresponding Author: Gablae Kim. Department of Orthopaedic Surgery, Hallym University Kangdong Sacred Heart Hospital, 150 Seongan-ro, Gangdong-gu, Seoul 05355, Korea. Tel: 82-2-2224-2230, Fax: 82-2-489-4391, kiga9@hallym.or.kr

Received 9 January 2017 Revised 1 February 2017 Accepted 2 February 2017

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Surgical treatments for arthritis in the first metatarsophalangeal joint include arthrodesis, interposition arthroplasty using silicone or meniscus cartilage, and rarely arthroplasty. Although arthrodesis was performed successfully, pain can persist if the angle of fusion was inappropriate. Interposition arthroplasty can be tried for the treatment of persisting pain after the arthrodesis. Interposition arthroplasty using tensor fascia lata is known that has low risk of adhesions and easy to harvest. Compared to autologous grafts, grafting rates is high and low risk of rejection additionally. Herein, we report a successfully managed arthritis with severe pain with interposition arthroplasty using tensor fascia lata after a failed metatarsophalangeal joint arthrodesis.

Keywords: Arthrodesis, Arthroplasty, Fascia lata, Metatarsophalangeal joint

Figures and Tables

Figure 1

(A) Anteroposterior view of preoperative plain radiograph with standing demonstrates metatarsophalangeal angle (MPA) was 23°. (B) Lateral view of preoperative plain radiograph with standing demonstrates MPA was 15°. (C, D) Axial view of preoperative computed tomography (CT), sagittal view of preoperative CT shows union of first metatarsophalangeal joint.

Figure 2

(A, B) Osteotomy was made from distal part of first metatarsophalangeal joint and proximal part of first metatarsophalangeal joint in dorsal side. (C) Operative finding of successful osteotomy of first metatarsophalangeal joint.

Figure 3

(A) Tensor fascia lata was harvested from lateral side of ipsilateral thigh. (B) The harvested tensor fascia lata. (C) The harvested tensor fascia lata folded in triplicate.

Figure 4

The harvested tensor fascia lata was inserted to first metatarsophalangeal joint and sutured with medial and lateral collateral ligaments.

Figure 5

Postoperative plain radiograph with standing at postoperative 3 months. (A) Anteriorposterior view demonstrates metatarsophalangeal angle (MPA) was 0°. (B) Lateral view demonstrates MPA was 25°.

Notes

^{Financial support} None.

^{Conflict of interest} None.

References

1. Hamilton WG, O'Malley MJ, Thompson FM, Kovatis PE. Roger Mann Award 1995. Capsular interposition arthroplasty for severe hallux rigidus. Foot Ankle Int. 1997; 18:68–70.

2. Hamilton GA, Ford LA, Patel S. First metatarsophalangeal joint arthrodesis and revision arthrodesis. Clin Podiatr Med Surg. 2009; 26:459–473.

3. Hahn MP, Gerhardt N, Thordarson DB. Medial capsular interpositional arthroplasty for severe hallux rigidus. Foot Ankle Int. 2009; 30:494–499.

4. Miller D, Maffulli N. Free gracilis interposition arthroplasty for severe hallux rigidus. Bull Hosp Jt Dis. 2005; 62:121–124.

5. Keiserman LS, Sammarco VJ, Sammarco GJ. Surgical treatment of the hallux rigidus. Foot Ankle Clin. 2005; 10:75–96.

6. Kennedy JG, Chow FY, Dines J, Gardner M, Bohne WH. Outcomes after interposition arthroplasty for treatment of hallux rigidus. Clin Orthop Relat Res. 2006; 445:210–215.

7. Cook E, Cook J, Rosenblum B, Landsman A, Giurini J, Basile P. Meta-analysis of first metatarsophalangeal joint implant arthroplasty. J Foot Ankle Surg. 2009; 48:180–190.

8. Lawrence BR, Thuen E. A retrospective review of the primus first MTP joint double-stemmed silicone implant. Foot Ankle Spec. 2013; 6:94–100.

9. Coughlin MJ, Shurnas PJ. Soft-tissue arthroplasty for hallux rigidus. Foot Ankle Int. 2003; 24:661–672.

10. Taghinia AH, Al-Sheikh AA, Upton J. Suture anchor suspension and fascia lata interposition arthroplasty for Basal joint arthritis of the thumb. Plast Reconstr Surg. 2008; 122:497–504.

TOOLS

Similar articles