Ultrasound Imaging Acquisition Procedures for Evaluating the First Metatarsophalangeal Joint: A Scoping Review

Therapeutic Interventions ◽

Scoping Reviews ◽

Key Concepts ◽

Review Protocol ◽

Corticosteroid Injections

ABSTRACTBackground: The two most common diseases affecting the first metatarso-phalangeal joint (1st MTP jt) of the foot are hallux limitus/rigidus (osteoarthritis) and hallux valgus (bunion), but other pathologies also affect the region. There are a range of treatments for these conditions: one treatment option is intra articular injection therapy, and this is one of the most common therapeutic interventions in musculoskeletal healthcare. Therapeutic injections of corticosteroids provide a treatment option for patients with joint or peri-articular pain, those who are not surgical candidates, in those in whom conservative treatment has failed or for those awaiting surgery. They are accepted as an important treatment modality, but currently there are no evidenced-based guidelines about administration technique or regimen of the 1st MTP jt. This is a scoping review protocol for the study to identify key concepts in intra-articular corticosteroid injections for pathology of the first metatarsophalangeal joint.Methods and analysis: Scoping reviews are used to assess and understand the extent of the knowledge in an emerging field or to identify, map, report, or discuss the characteristics or concepts in that field. The Joanna Briggs Institute (JBI) is an international research organisation based in the Faculty of Health and Medical Sciences at the University of Adelaide. The JBI develops and delivers evidence-based information, software, education, and training and its guidance is widely cited across a range of disciplines, academic fields, and professional backgrounds. This scoping review will follow the JBI process who recommend the PCC framework (‘Population–Concept–Context’) to frame the research question. The ‘Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for Scoping Reviews’ will be used to guide the reporting of this protocol and will also subsequently be used to structure the reporting of the full review (PRISMA-ScR). Dissemination: Findings will be presented to explore speciality-specific and profession-specific commonalities and differences. The scoping review results will be disseminated via publication in peer-reviewed journals (it is envisaged that at least two publications will be developed) and presentation at national/international conferences.

Correlation analysis of the x-ray and functional parameters from the results of chevron (Austin) osteotomy for hallux valgus

Vrač skoroj pomoŝi (Emergency Doctor) ◽

10.33920/med-02-2005-07 ◽

2020 ◽

pp. 54-63

Author(s):

Ruslan Khairutdinov ◽

Timur Minasov ◽

Ekaterina Yakupova ◽

Elvina Mukhametzyanova

Keyword(s):

Hallux Valgus ◽

Rating Scale ◽

Valgus Deformity ◽

Chevron Osteotomy ◽

Hallux Valgus Deformity ◽

Valgus Angle ◽

The Right ◽

Bone Structures

Hallux valgus is characterized by the appearance and growth of a painful “lump” in the region of the first metatarsophalangeal joint, the development of forefoot corns, and inability to choose the right shoes, which leads to a significant decrease in the quality of life of these patients. Corrective osteotomies that preserve the metatarsophalangeal joint, for example Austin (Chevron) osteotomy, are usually used for hallux valgus deformity of the I, II degrees. Radiography with the study of the hallux valgus angle (HVA), the intermetatarsal angle (IMA), the distal metatarsal articular angle (DMAA) is a research method that shows the true correlation between bone structures. The correlation between the radiological and functional indicators of osteotomy allows us to determine possible recommendations for indications for surgical treatment of Hallux valgus. Correlation shows that the largest correction of hallux valgus in older patients occurs due to a small adjustment of the angle of DMMA and HVA. IMA had the best correction after Austin osteotomy among patients of a younger age, then the HVA, and the DMMA had minimum correction according to the AOFAS rating scale (Kitaoka). The revealed correlations allow us to determine the correct tactics for the treatment of hallux valgus by identifying the benefits of Austin osteotomy.

Structural characteristics associated with radiographic severity of first metatarsophalangeal joint osteoarthritis

Arthritis Care & Research ◽

10.1002/acr.24227 ◽

2020 ◽

Author(s):

Andrew K Buldt ◽

Shannon E Munteanu ◽

Jamie J Allan ◽

Jade M Tan ◽

Maria Auhl ◽

...

Keyword(s):

Structural Characteristics ◽

Radiographic Severity

Temporary Kirschner wire fixation of the first metatarsophalangeal joint before osteotomy for hallux valgus

International Journal of Surgery Case Reports ◽

10.1016/j.ijscr.2021.106104 ◽

2021 ◽

pp. 106104

Author(s):

Ichiro Tonogai ◽

Koichi Sairyo

Keyword(s):

Hallux Valgus ◽

Kirschner Wire ◽

Kirschner Wire Fixation ◽

Wire Fixation

Percutaneous First Metatarsophalangeal Joint Arthrodesis

Foot & Ankle Surgery: Techniques, Reports & Cases ◽

10.1016/j.fastrc.2021.100041 ◽

2021 ◽

pp. 100041

Author(s):

Bradley P. Abicht

Keyword(s):

First Metatarsophalangeal Joint

Treatment of End-Stage Hallux Rigidus and Impact of Arthrodesis versus Arthroplasty on Patient Reported Outcomes

Foot & Ankle Orthopaedics ◽

10.1177/2473011417s000129 ◽

2017 ◽

Vol 2 (3) ◽

pp. 2473011417S0001

Author(s):

Monique Chambers ◽

MaCalus Hogan ◽

Dukens LaBaze

Keyword(s):

Patient Reported Outcomes ◽

Surgical Intervention ◽

Hallux Rigidus ◽

Significant Difference ◽

Patient Reported ◽

Outcome Scores ◽

Vas Scores ◽

End Stage

Category: Bunion, Midfoot/Forefoot Introduction/Purpose: Hallux rigidus is a degenerative disease of the first metatarsophalangeal joint. Severe, end-stage hallux rigidus can become debilitating with surgical intervention becoming necessary once conservative measures and shoe modifications have failed. Joint salvage procedures include metatarsal phalangeal (MTP) arthrodesis and MTP arthroplasty. The purpose of this study was to assess for differences in patient reported outcomes in two cohorts who underwent fusion or joint reconstruction. Methods: This study was a retrospective review of prospectively collected data of 385 patients from an academic medical institution. Patients who underwent surgical intervention from July 2015 to November 2016 were identified based on CPT codes for MTP arthrodesis (28750) and arthroplasty (28293). We extracted outcome scores including SF12-M, SF12-P, FAAM, and VAS scores. Exclusion criteria included poly-trauma, revision procedures, and lack of pre and post-operative outcome scores. Mann- Whitney t-test was performed using GraphPad Prism version 7.0b for Mac to compare procedure groups, with significance define by a p-value of 0.05. Results: A total of eighteen patients met the inclusion criteria, with 6 who underwent arthroplasty and 12 arthrodesis. The average age was 63.7 amongst the cohort, with a total of 16 female and 2 males. Patients who underwent arthrodesis had better outcomes across all parameters. When comparing preoperative and postoperative scores, arthrodesis patients showed greater improvement of SF12-M (arthrodesis 9 vs arthroplasty -2, p=0.05), and SF12-P (9 vs -16, respectively p=0.05) scores. Arthroplasty patients were more likely to have a decrease in their SF-12 scores. VAS scores and FAAM scores showed no statistical difference between the two cohorts. Postoperative VAS scores were worse in 33% of arthroplasty patients despite surgical intervention, compared to 10% of arthrodesis patients. Conclusion: Our results suggests that both procedures provide a statistically significant difference in pain with several patients having a Global Rate of Change that is “very much better”. However, fusion of the metatarsophalangeal joint results in improved pain and functional outcomes for patients with severe hallux rigidus. These findings are consistent with current reports in the literature, which are mostly case series reports. Larger studies are needed to provide appropriate power and better support the findings of this study.