Foot & ankle international · 2026
Outcomes of Iliac Crest Bone-Block Arthrodesis After Failed First MTP Joint Surgery With Bone Loss.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
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Mantı Nurettin, Atalay Melih, Ülgen Nuri Koray, Akkurt Mehmet Orçun, Erginoğlu Sadık Emre, Öznur Ali
Аннотация
BACKGROUND: Failed first metatarsophalangeal (MTP) joint surgery with bone loss is a challenging revision problem. This study aimed to evaluate the radiographic and clinical outcomes of iliac crest bone-block arthrodesis in this setting.
METHODS: This retrospective cohort included 72 patients who underwent revision first MTP arthrodesis with tricortical iliac crest autograft between 2018 and 2022. All patients had at least 2 years of clinical and radiographic follow-up, and 83.3% had at least 3 years of follow-up. Fusion rates, complications, and changes in visual analog scale (VAS) and 36-Item Short Form Health Survey (SF-36) scores were recorded; the influence of age, comorbidities, and graft length was explored.
RESULTS: The median time from the index procedure to revision was 24 months, and the median graft length 11 mm. Primary radiographic union was achieved in 67 of 72 patients (93.1%); after secondary grafting in 3 additional patients, final radiographic union was 70 of 72 (97.2%), with persistent nonunion in 2 patients (2.8%); 44.4% had at least 1 complication and 6.9% required further surgery. Median VAS improved from 8 (7.8-9.0) preoperatively to 0 (0-1.0) at 24 months, and SF-36 improved from 55 (50-62) to 88 (82-90). Exploratory analyses suggested that systemic comorbidities and longer graft length were associated with less favorable pain and functional outcomes.
CONCLUSION: Iliac crest bone-block arthrodesis may be an acceptable salvage option after failed first MTP joint surgery with bone loss, achieving a high radiographic union rate and meaningful clinical improvement; however, postoperative complications were frequent, and outcomes were less favorable in patients with systemic comorbidities or larger structural defects.
LEVEL OF EVIDENCE: Level IV, non-comparative retrospective cohort.
METHODS: This retrospective cohort included 72 patients who underwent revision first MTP arthrodesis with tricortical iliac crest autograft between 2018 and 2022. All patients had at least 2 years of clinical and radiographic follow-up, and 83.3% had at least 3 years of follow-up. Fusion rates, complications, and changes in visual analog scale (VAS) and 36-Item Short Form Health Survey (SF-36) scores were recorded; the influence of age, comorbidities, and graft length was explored.
RESULTS: The median time from the index procedure to revision was 24 months, and the median graft length 11 mm. Primary radiographic union was achieved in 67 of 72 patients (93.1%); after secondary grafting in 3 additional patients, final radiographic union was 70 of 72 (97.2%), with persistent nonunion in 2 patients (2.8%); 44.4% had at least 1 complication and 6.9% required further surgery. Median VAS improved from 8 (7.8-9.0) preoperatively to 0 (0-1.0) at 24 months, and SF-36 improved from 55 (50-62) to 88 (82-90). Exploratory analyses suggested that systemic comorbidities and longer graft length were associated with less favorable pain and functional outcomes.
CONCLUSION: Iliac crest bone-block arthrodesis may be an acceptable salvage option after failed first MTP joint surgery with bone loss, achieving a high radiographic union rate and meaningful clinical improvement; however, postoperative complications were frequent, and outcomes were less favorable in patients with systemic comorbidities or larger structural defects.
LEVEL OF EVIDENCE: Level IV, non-comparative retrospective cohort.