scholarly journals Appropriate Distraction Strength of Metatarsopahlangeal Joint Arthroscopy

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0032
Author(s):  
Kwang-Bok Lee ◽  
Jongkil Kim
Keyword(s):  
Body Mass Index ◽  
Associated Factors ◽  
Plain Radiograph ◽  
Metatarsophalangeal Joint ◽  
High Definition ◽  
Old Patients ◽  
Female Patients ◽  
Iatrogenic Complications ◽  
Significant Difference ◽  
Manual Traction

Category: Arthroscopy; Bunion; Lesser Toes Introduction/Purpose: Appropriate distraction for metatarsophalangeal joint arthroscopy is paramount to increase in visualization and to decrease iatrogenic complications. However, there are few studies on how much adequate distraction is. The purpose of this study was to investigate the appropriate degree of distraction and the associated factors. Methods: 40 patients who underwent toe arthroscopy from April 2015 to June 2018 were enrolled. Under general or spinal anesthesia, the anterio-posterior foot plain radiograph were taken using mini-fluoroscan; no traction, manual traction, 5, 10 and 15 pound traction and were used to measure the metatasophalangeal joint (MTP) distance. Age, gender, body mass index were compared as associated factors. The minimum joint distance of toe arthroscopy defined as 2.8mm which was sheath size of 1.9mm 30° high definition arthroscopy. Appropriate distraction is defined as an over 70% possible rate. Results: 10lb traction was appropriate distraction on first and fourth MTP joint arthroscopy. 5lb traction was appropriate on second, third, fifth MTP. In first MTP with 5lb traction, there was significant difference according to gender; 9 of 23 male, none of 17 female. (p=0.005). With 10lb traction, 16 of 27 patients under 60 and 3 of 13 patients over 60 years old were could arthroscopy (p=0.046). In third MTP with 5lb traction, 18 of 28 patients over 30 were could arthroscopy, but only 4 of 13 under 30 years old were could(p=0.038). In fourth MTP with 5lb traction, there was significant difference according to gender, male (12 of 23 patients) was had arthroscopy, but only 2 of 17 female patients. (p=0.017). Conclusion: In the MTP joint arthroscopy, 10lb was needed in first and fourth MTP joint, and 5lb was needed in second, third, fifth MTP joint. Manual traction is generally not appropriate for distraction. Female and under 60 years old patients needed more distraction in first toe arthroscopy. Under 30 years old patients in third toe and female patients in fourth toe arthroscopy needed more distraction than 5lb. [Table: see text]

scholarly journals Appropriate Distraction Strength For Metatarsophalangeal Joint Arthroscopy

2021 ◽  
Author(s):  
Jong-Kil Kim ◽  
Do-Yeon Kim ◽  
Kwang-Bok Lee
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Associated Factors ◽  
Metatarsophalangeal Joint ◽  
Joint Space ◽  
Space Size ◽  
Mtp Joints ◽  
Manual Traction ◽  
Traction Power

Abstract This study is to investigate the natural metatasophalangeal joint (MTP) distance, the appropriate degree of distraction and the associated factors including age, gender, body mass index(BMI). Regarding natural MTP joint space size, the MTP-2 joint had the largest joint size (2.39 ± 0.37 mm). The MTP-5 joint had the smallest joint size (1.59 ± 0.34 mm). In MTP joint arthroscopy, traction power of 10 lbs is sufficient for appropriate distraction for all MTP joints while traction power of 5 lbs is an appropriate power for distraction of the MTP-2 joint. Manual traction is generally not appropriate for distraction because it is not consistent or sufficient. Less distraction power is required for males than for females, especially for MTP-1, MTP-3, and MTP-4 joints.

Prognostic Impact of Mutations in the Nucleophosmin (NPM1) and of the FMS-Related Tyrosine Kinase 3 (FLT3) Genes in Elderly Patients with Acute Myeloid Leukemia (AML) Treated with Intensive Chemotherapy

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 2542-2542 ◽  
Author(s):  
Anne Etienne ◽  
Cecile Borel ◽  
Sarah Reutenauer ◽  
Sylviane Olschwang ◽  
Marie-Joelle Mozziconacci ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Young Patients ◽  
Genetic Alterations ◽  
Prognostic Impact ◽  
Wild Type ◽  
Old Patients ◽  
Npm1 Mutation ◽  
Female Patients ◽  
Cell Counts ◽  
Significant Difference

Abstract AML is a heterogeneous disease and the actual most reliable prognostic factor is the karyotype. Mutations of NPM1 and FLT3 constitute the most frequent molecular genetic alterations in patients with AML. Their prognostic impact is now well recognized, especially in young patients with intermediate prognosis karyotype. However few studies have focused on elderly patients. We retrospectively studied the prevalence of NPM1 mutation and FLT3 internal tandem duplications (ITD) and its association with complete remission (CR) and survival in 86 patients aged 61 years or older treated between 1996 and 2007 for acute non promyelocytic leukemia with intermediate karyotype in the Institut Paoli-Calmettes, Marseille, and the university hospital of Toulouse. All patients received intensive induction chemotherapy (“3+7” regimen). Median age was 70 years (range, 61–79). The median follow-up of surviving patients was 34 months. 44 patients (51%) had NPM1 mutation and 21 had FLT3-ITD (24%). In the NPM1 mutated group, there were significantly more: female patients, absence of antecedent hematologic disorder, de novo AML, and low CD34 expression. In the FLT3-ITD group, there were significantly more: female patients, increased white blood cell counts and peripheral blood blasts. Overall CR rate was 67%; median disease free survival (DFS) and overall survival (OS) were 11 and 10 months, respectively. CR rate was negatively associated with a poor performans status and a high score previously described including assessment of comorbidities (Etienne et al., Cancer2007; 109(7):1376–83). CR rate was 57% versus 72% for patients with FLT3-ITD compared to patients with wild-type FLT3 (p 0.2), and 64% versus 71% for the NPM1 mutated group compared with the NPM1 non-mutated group (p 0.5). Median OS was 6 months versus 12 months for patients with FLT3-ITD mutation versus wild type patients (p = 0.04). Median OS was 9 months for patients with NPM1 mutation and did not differ from non-mutated patients. No significant difference in term of CR rate and OS was found between the 29 patients carrying NPM1 mutation without FLT3-ITD and the 57 other patients without NPM1 mutation or with FLT3-ITD. Median DFS was 21 months versus 9 months for these two groups, respectively (p 0.2). These results confirm the prognostic impact of FLT3-ITD in our series of old patients with AML. Unlike young patients, NPM1 mutated elderly patients have a similar outcome than NPM1 wild type patients. The absence of prognostic impact of NPM1 mutation without FLT3-ITD has to be validated on larger prospective cohort. FLT3 status should be taken into account for treatment choices in elderly patients.

Ultrasound Accuracy in Diagnosing Appendicitis in Obese Pediatric Patients

2017 ◽  
Vol 83 (10) ◽  
pp. 1063-1067 ◽  
Author(s):  
Bryan E. Love ◽  
Monica Camelo ◽  
Sarvenaz Nouri ◽  
Diego Kriger ◽  
Daniel Ludi ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Retrospective Review ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Overweight Children ◽  
Old Patients ◽  
Significant Difference ◽  
Ultrasound Technology

The use of ultrasound to diagnose appendicitis in pediatric patients has been growing with the improvement of ultrasound technology and operator skills, but its utility in the increasingly obese pediatric population has not been thoroughly investigated. A retrospective review of all pediatric (≤18 years old) patients with appendicitis who were admitted at a single hospital from 2014 to 2016 was conducted. Patients were stratified into body mass index (BMI) percentile categories based on the centers for disease control guidelines. Comparisons were then made. There were 231 patients with an average BMI percentile of 72.6; 99 (42.9%) who had an ultrasound, of which 54 (54.5%) were positive for acute appendicitis, whereas 43 (43.4%) were nondiagnostic. In patients who had a nondiagnostic ultrasound, 37 had a CT demonstrating acute appendicitis. These were compared with 123 patients who had CT alone demonstrating acute appendicitis. The CT-only group was older (12 vs 9, P < 0.005), tended to be male (78 (63%) vs 15 (41%), P = 0.019), had fewer operations performed (81 (66%) vs 30 (81%), P = 0.048) but had no significant difference in BMI percentile (75.8 vs 71.7, P = 0.465). Ultrasound had a 100 per cent positive predictive value in obese and overweight children. Ultrasound is a reliable study in obese and overweight pediatric patients with acute appendicitis.

Postpartum Depression and Its Associated Factors among Women in Bandar Abbas City

2018 ◽  
Vol 7 ◽  
Author(s):  
Arefeh Shahi
Keyword(s):  
Postpartum Depression ◽  
Associated Factors ◽  
Parental Education ◽  
Unwanted Pregnancy ◽  
Routine Care ◽  
Cross Sectional Study ◽  
Vulnerable Groups ◽  
Cross Sectional ◽  
Significant Difference ◽  
Bandar Abbas

Background: Postpartum depression with a different incidence of 40- 45% in different societies, which it has adverse effects on the health of mothers and their child, given the negative effects of maternal depression and its harmful effects on the baby and the quality of family life. So, this study was performed with the aim to determine postpartum depression and its associated factors in Bandar Abbas city. Materials and Methods: A descriptive cross-sectional study was conducted in 2015 after obtaining consent from mothers by the census. A total of 343 mothers was examined for depression who referred to Bandar Abbas health centers in the 2nd and 4th months after childbirth. The data collection tools included demographic information and Postpartum Depression Edinburgh questionnaires. Finally, the statistical analyses were performed using SPSS (version 22.0) software and data were analyzed using the Independent t-test, Mann Whitney, Chi-square, and Fisher exact tests.Result: Totally, 68 (19.8%) of samples were in the second month and 54 (15.7%) in the fourth month after delivery had postpartum depression. The incidence of depression in the four months was 6.6%. There was a significant difference between depression and income, parental education, father’s use of cigarette and abnormalities of the infant (P <0.001). There was no significant difference between other factors such as gestational age, infant sex, birth weight, unwanted pregnancy, and type of delivery. Conclusion: Regarding the prevalence of this disorder, it seems that postpartum depression screening planning should be considered during child routine care as an essential component, especially for vulnerable groups.

scholarly journals Effect of mobile guided cardiac rehabilitation on quality of life – the EU-CaRE randomised clinical trial

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
V Houben ◽  
J.A Snoek ◽  
E Prescott ◽  
N Mikkelsen ◽  
A.E Van Der Velde ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Elderly Patients ◽  
Cardiac Rehabilitation ◽  
Control Group ◽  
Funding Source ◽  
Multi Centre Study ◽  
Old Patients ◽  
Home Based ◽  
Significant Difference

Abstract Background and purpose Although participation in cardiac rehabilitation (CR) improves quality of life (QoL), participation in CR, especially among elderly, is limited. We conducted this study to assess whether mobile home-based CR (mCR) increases QoL in elderly (≥65 years old) patients with coronary artery disease (CAD) or a valvular intervention who decline participation in conventional CR. Methods It is designed as a randomised multi-centre study with two parallel arms. Randomisation assigned patients either to mCR or a control group. mCR Consisted of six months of home-based CR with telemonitoring and coaching. Control-group patients did not receive any form of CR throughout the study period. Quality of life was measured with the SF-36v2 questionnaire at 0, 6 and 12 months. Results A total of 179 patients were included in this study (90 control, 89 mCR). A flowchart of the trial is presented in Figure 1. Patients were predominantly male (81.1%). Baseline characteristics can be found in Table 1. Patients using mCR improved on physical QoL after 6 (p=0.026) and 12 (p=0.008) months. There was no difference on mental QoL for both groups (mCR 6 months p=0.563, 12 months p=0.945; control 6 months p=0.589, 12 months p=0.542). No difference existed in QoL between the mCR and control group (physical: 6 months p=0.070, 12 months p=0.150; mental: 6 months p=0.355, 12 months p=0.625). Conclusion Although there is no significant difference in QoL between the control and mCR group, mCR increases physical QoL after 6 and 12 months in elderly patients who decline participation in conventional CR. Therefore E-Health tools should be considered as an alternative for conventional CR when (elderly) patients decline to participate in conventional CR. Figure 1. Flow chart of all eligible patients Funding Acknowledgement Type of funding source: Public grant(s) – EU funding. Main funding source(s): European Union's Horizon 2020 research and innovation programme

scholarly journals OP0220 ASSESSING THE EFFECT OF INCREASED BODY MASS INDEX ON RESPONSE TO TNF INHIBITORS IN ESTABLISHED RHEUMATOID ARTHRITIS: RESULTS FROM THE METEOR DATABASE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 137.1-137
Author(s):  
M. Dey ◽  
S. S. Zhao ◽  
R. J. Moots ◽  
R. B. M. Landewé ◽  
N. Goodson
Keyword(s):  
Rheumatoid Arthritis ◽  
Body Mass Index ◽  
Body Mass ◽  
Personalised Medicine ◽  
Normal Weight ◽  
Sensitivity Analyses ◽  
Established Rheumatoid Arthritis ◽  
Eular Response ◽  
Significant Difference ◽  
Das28 Remission

Background:Rheumatoid arthritis (RA) is associated with increased body mass index (BMI)- 60% of patients are either overweight or obese. Obesity in RA has been shown to predict reduced response to biologic therapy including tumour-necrosis-factor inhibitors (TNFi) [1]. However, it is not clear whether increased BMI influences response to all TNFi drugs in RA.Objectives:1.To explore whether BMI is associated with response to TNFi in patients with established rheumatoid arthritis (estRA), including those newly-starting on these drugs.Methods:Participants with estRA (>1year since diagnosis) taking biologic medications, registered on METEOR (international database of RA patients), 2008-2013, were included. EULAR response, DAS28 remission (including components), and treatment regimens were recorded at baseline, 6, and 12 months. WHO definitions of overweight (BMI≥ 25) and obese (BMI≥30) were explored as predictors of TNFi response (good EULAR response and DAS28 remission) using normal BMI as comparator. Logistic and linear regression models (controlling for age, gender, smoking, and baseline outcomes) and sensitivity analyses were performed. Subgroup analyses were performed for grouped TNFi and individual TNFi (infliximab, IFX; adalimumab, ADA; etanercept, ETN).Results:247 patients with estRA were taking a biologic at 6 months, and 231 patients were taking a biologic at 12 months. Obese patients taking any biologic were significantly less likely to achieve DAS28 remission (OR 0.33 [95%CI 0.12-0.80]) or good EULAR response (OR 0.37 [95%CI 0.16-0.81]) after 6 months, compared to those of normal BMI; this was also demonstrated in those co-prescribed methotrexate (DAS28 remission: OR 0.23 [95%CI 0.07-0.62]; good EULAR response: OR 0.39 [95%CI 0.15-0.92]). These associations did not remain statistically significant at the 12 months assessment.Regarding specific anti-TNF therapies, RA patients treated with monoclonal antibody (-mab) TNFis (IFX/ADA/ GOL) were significantly less likely to achieve good EULAR response at 6 months if they were obese RA (n=38), compared to those of normal weight (n=44) (OR 0.17 [95%CI 0.03-0.59]). A similar non-significant difference was demonstrated for DAS28 remission, and 12-month remission. Specifically, obese individuals were significantly less likely to achieve good EULAR response at 6 months with IFX (OR 0.09 [95%CI 0.00-0.61]; n=20), and significantly less likely to achieve DAS28 remission at 6 months when newly-starting ADA (OR 0.14 [95%CI 0.01-0.96]; n=17), compared to those of normal weight. There were no significant differences in remission outcomes between individuals of different BMI taking ETN. A small number of individuals stopped taking their respective biologic after 6months; reason for cessation was not recorded.Similar outcomes were seen in patients already established on anti-TNF therapy, with overweight and obese individuals less likely overall to be in DAS28 remission at all time points.Conclusion:In established RA, obesity is associated with reduced treatment response to -mab TNFi. No association between increased BMI and response to ETA was observed. Using BMI to direct biologic drug choice could prove to be a simple and cost-effective personalised-medicine approach to prescribing.References:[1]Schäfer M, Meißner Y, Kekow J, Berger S, Remstedt S, Manger B, et al. Obesity reduces the real-world effectiveness of cytokine-targeted but not cell-targeted disease-modifying agents in rheumatoid arthritis. Rheumatology. 2019 Nov 20.Disclosure of Interests:Mrinalini Dey: None declared, Sizheng Steven Zhao: None declared, Robert J Moots: None declared, Robert B.M. Landewé Consultant of: AbbVie; AstraZeneca; Bristol-Myers Squibb; Eli Lilly & Co.; Galapagos NV; Novartis; Pfizer; UCB Pharma, Nicola Goodson: None declared

scholarly journals Body mass index and clinical outcomes in patients with intracerebral haemorrhage: results from the China Stroke Center Alliance

2021 ◽  
pp. svn-2020-000534
Author(s):  
Zhentang Cao ◽  
Xinmin Liu ◽  
Zixiao Li ◽  
Hongqiu Gu ◽  
Yingyu Jiang ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Hospital Mortality ◽  
Body Mass ◽  
Intracerebral Haemorrhage ◽  
Final Analysis ◽  
Normal Weight ◽  
Discharge Disposition ◽  
Increased Risk ◽  
Significant Difference ◽  
Stroke Center

Background and aimObesity paradox has aroused increasing concern in recent years. However, impact of obesity on outcomes in intracerebral haemorrhage (ICH) remains unclear. This study aimed to evaluate association of body mass index (BMI) with in-hospital mortality, complications and discharge disposition in ICH.MethodsData were from 85 705 ICH enrolled in the China Stroke Center Alliance study. Patients were divided into four groups: underweight, normal weight, overweight and obese according to Asian-Pacific criteria. The primary outcome was in-hospital mortality. The secondary outcomes included non-routine discharge disposition and in-hospital complications. Discharge to graded II or III hospital, community hospital or rehabilitation facilities was considered non-routine disposition. Multivariable logistic regression analysed association of BMI with outcomes.Results82 789 patients with ICH were included in the final analysis. Underweight (OR=2.057, 95% CI 1.193 to 3.550) patients had higher odds of in-hospital mortality than those with normal weight after adjusting for covariates, but no significant difference was observed for patients who were overweight or obese. No significant association was found between BMI and non-disposition. Underweight was associated with increased odds of several complications, including pneumonia (OR 1.343, 95% CI 1.138 to 1.584), poor swallow function (OR 1.351, 95% CI 1.122 to 1.628) and urinary tract infection (OR 1.532, 95% CI 1.064 to 2.204). Moreover, obese patients had higher odds of haematoma expansion (OR 1.326, 95% CI 1.168 to 1.504), deep vein thrombosis (OR 1.506, 95% CI 1.165 to 1.947) and gastrointestinal bleeding (OR 1.257, 95% CI 1.027 to 1.539).ConclusionsIn patients with ICH, being underweight was associated with increased in-hospital mortality. Being underweight and obese can both increased risk of in-hospital complications compared with having normal weight.

scholarly journals Regional muscle-adipose distribution is different in patients with heart failure with preserved or reduced ejection fraction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
H Ishikawa ◽  
Y Izumiya ◽  
A Shibata ◽  
T Yoshida ◽  
H Hayashi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Body Mass Index ◽  
Adipose Tissue ◽  
Ejection Fraction ◽  
Exercise Capacity ◽  
Exercise Tolerance ◽  
The Other ◽  
Reduced Ejection Fraction ◽  
Significant Difference ◽  
Regional Muscle

Abstract Background Epicardial adipose tissue (EAT) has been recognized to contribute inflammatory activity and atherosclerosis. On the other hand, it has been reported that the volume of EAT is lower in non-ischemic heart failure (HF) patients than healthy individuals. However, the difference in regional muscle-adipose distribution including EAT between HF with preserved ejection fraction (HFpEF) and HF reduced ejection fraction (HFrEF) has not been investigated. In addition, we investigated whether distribution of body composition contributed to exercise capacity. Methods The study included 105 non-ischemic HF patients diagnosed by cardiac catheterization between September 2017 and November 2019. Epicardial, abdominal and thigh muscle and adipose tissue volume were measured by computed tomography (CT), and exercise tolerance was evaluated by symptom-limited cardiopulmonary exercise test. Results Patients were divided into 2 groups according to the left ventricular ejection fraction, ≥40% as HFpEF (n=28) or &lt;40% as HFrEF (n=77). There was no significant difference comorbidity, including hypertension, dyslipidemia, chronic kidney disease, and body mass index. Plasma B-type natriuretic peptide level was significantly higher in HFrEF than HFpEF group (146.2 vs 393.2 pg/ml, p&lt;0.01), whereas, high-sensitive troponin T level was not different between two groups. Although there was no significant difference in BMI between two groups, the volume of EAT was significantly higher in HFpEF than HFrEF group (81.8 vs 136.4 ml, p=0.01). On the other hand, HFpEF had more thigh adipose tissue compared with HFrEF group (54.6 vs 42.1 ml, p=0.03). There were negative correlations between EAT volume and parameters of exercise capacity such as anaerobic threshold (r=−0.42, p&lt;0.01) and peak VO2 (r=−0.32, p&lt;0.01). Muscle volume itself does not corelate with these parameters. Conclusion In patient with nonischemic HF, the pattern of regional adipose distribution may have important role in pathologically. HFpEF and HFrEF has different pattern despite similar body mass index. These differences may be related to impaired exercise tolerance in these 2 different types of HF. Correlation between EAT and AT, peak VO2 Funding Acknowledgement Type of funding source: None

scholarly journals Clinical characteristics and longitudinal changes of patients with non-alcoholic fatty liver disease in 2 decades: the NAGALA study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Takuro Okamura ◽  
Yoshitaka Hashimoto ◽  
Masahide Hamaguchi ◽  
Akihiro Obora ◽  
Takao Kojima ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Liver Disease ◽  
Fatty Liver ◽  
Body Mass ◽  
Fatty Liver Disease ◽  
Abdominal Ultrasonography ◽  
Alcoholic Fatty Liver ◽  
The Past ◽  
Significant Difference ◽  
Alcoholic Fatty Liver Disease

Abstract Background In this study, to clarify the evolving background of people with non-alcoholic fatty liver disease (NAFLD), we compared the current prevalence of NAFLD with that of 2 decades ago. Methods We included two cohorts. The past cohort was from 1994 to 1997 and included 4279 men and 2502 women. The current cohort was from 2014 to 2017 and included 8918 men and 7361 women. NAFLD was diagnosed by abdominal ultrasonography. Results The prevalence of NAFLD increased in both genders throughout these 2 decades (18.5% in the past cohort and 27.1% in the current cohort for men; and 8.0% in the past cohort and 9.4% in the current cohort for women). The prevalence of hyperglycemia increased, whereas the prevalence of low high-density lipoprotein cholesterol levels and hypertriglyceridemia significantly decreased. There was no significant difference in the mean body mass index. Multivariate analysis revealed that the prevalence of obesity and body mass index were significantly associated with the prevalence of NAFLD in both the past and current cohorts. Conclusions The incidence of NAFLD significantly increased throughout these 2 decades, and obesity is the most prevalent factor. Thus, body weight management is an essential treatment option for NAFLD.

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

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0001
Author(s):  
Monique Chambers ◽  
MaCalus Hogan ◽  
Dukens LaBaze
Keyword(s):  
Patient Reported Outcomes ◽  
Surgical Intervention ◽  
Metatarsophalangeal Joint ◽  
Hallux Rigidus ◽  
First Metatarsophalangeal Joint ◽  
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.

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