Arthrodesis Seems to Be Effective in Midfoot Arthritis

Major Finding: Union occurred in 92% of 104 feet after the primary operation, and fusion after revision occurred in 99%. Most of the patients (90%) were satisfied with the results.

Data Source: Retrospective study of 95 patients with midfoot arthritis.

Disclosures: Dr. Nemec and his coinvestigators reported that they have no relevant financial relationships.

NATIONAL HARBOR, MD. ' Arthrodesis is a safe procedure for midfoot arthritis, with an excellent union rate and high patient satisfaction, according to findings in a small, retrospective study.

Union was achieved in 92% of 104 feet after the primary operation, and fusion after revision was achieved in 99%. In addition, most of the patients (90%) were satisfied with the results of their procedures, reported Dr. Scott A. Nemec.

Patients included in the study had primary midfoot arthritis with or without radiologic or clinical arch collapse. The researchers identified 95 patients (104 feet) who had undergone arthrodesis. Most were women and their mean age was 61 years. The primary indication for surgery was disabling foot pain that was not relieved by other measures. On radiograph, pre-and postoperative measurements were made of the anteroposterior talus and first metatarsal angle, the lateral talus and first metatarsal angle, the medial cuneiform height, and the talonavicular uncoverage.

Other outcomes included complications and reoperations, the AOFAS midfoot score, the visual analog scale pain score (0-10), and patient satisfaction.

In all, 297 joints were fused – roughly 3 per patient. Gastrocnemius recession was performed in 80% of the feet, and 56% had a forefoot procedure. In terms of bone grafts used, autograft was used in 91% of the feet, allograft in 4%, and no grafts were used for 5%. The most commonly fused joints were the first, second, and third tarsometatarsals and the naviculocuneiform. No further surgery was required for one asymptomatic third TMT nonunion. One delayed union was consolidated with immobilization. Radiographically, improvement was seen in all parameters.

Major complications included three deep infections and one instance of chronic pain. The infections were treated with debridement. The patient with chronic pain was referred to a pain clinic.

There were 11 reoperations—7 for refusion, 3 for debridement, and 1 gastrocnemius recession. Four of the refusion patients and one debridement patient were not satisfied with their results. Hardware removal was required for a quarter of the feet at an average of 20 months, said Dr. Nemec, who is an orthopedic specialist in private practice in Petoskey, Mich.

Patient-reported outcome data were available for 68 patients (74 feet), with a mean follow-up of 56 months. The visual analog scale pain score dropped by a significant average of 4.6 points after surgery. The AOFAS score increased by a significant 47 points (maximum 100).

Major Finding: Union occurred in 92% of 104 feet after the primary operation, and fusion after revision occurred in 99%. Most of the patients (90%) were satisfied with the results.

Data Source: Retrospective study of 95 patients with midfoot arthritis.

Disclosures: Dr. Nemec and his coinvestigators reported that they have no relevant financial relationships.

NATIONAL HARBOR, MD. ' Arthrodesis is a safe procedure for midfoot arthritis, with an excellent union rate and high patient satisfaction, according to findings in a small, retrospective study.

Union was achieved in 92% of 104 feet after the primary operation, and fusion after revision was achieved in 99%. In addition, most of the patients (90%) were satisfied with the results of their procedures, reported Dr. Scott A. Nemec.

Patients included in the study had primary midfoot arthritis with or without radiologic or clinical arch collapse. The researchers identified 95 patients (104 feet) who had undergone arthrodesis. Most were women and their mean age was 61 years. The primary indication for surgery was disabling foot pain that was not relieved by other measures. On radiograph, pre-and postoperative measurements were made of the anteroposterior talus and first metatarsal angle, the lateral talus and first metatarsal angle, the medial cuneiform height, and the talonavicular uncoverage.

Other outcomes included complications and reoperations, the AOFAS midfoot score, the visual analog scale pain score (0-10), and patient satisfaction.

In all, 297 joints were fused – roughly 3 per patient. Gastrocnemius recession was performed in 80% of the feet, and 56% had a forefoot procedure. In terms of bone grafts used, autograft was used in 91% of the feet, allograft in 4%, and no grafts were used for 5%. The most commonly fused joints were the first, second, and third tarsometatarsals and the naviculocuneiform. No further surgery was required for one asymptomatic third TMT nonunion. One delayed union was consolidated with immobilization. Radiographically, improvement was seen in all parameters.

Major complications included three deep infections and one instance of chronic pain. The infections were treated with debridement. The patient with chronic pain was referred to a pain clinic.

There were 11 reoperations—7 for refusion, 3 for debridement, and 1 gastrocnemius recession. Four of the refusion patients and one debridement patient were not satisfied with their results. Hardware removal was required for a quarter of the feet at an average of 20 months, said Dr. Nemec, who is an orthopedic specialist in private practice in Petoskey, Mich.

Patient-reported outcome data were available for 68 patients (74 feet), with a mean follow-up of 56 months. The visual analog scale pain score dropped by a significant average of 4.6 points after surgery. The AOFAS score increased by a significant 47 points (maximum 100).

Major Finding: Union occurred in 92% of 104 feet after the primary operation, and fusion after revision occurred in 99%. Most of the patients (90%) were satisfied with the results.

Data Source: Retrospective study of 95 patients with midfoot arthritis.

Disclosures: Dr. Nemec and his coinvestigators reported that they have no relevant financial relationships.

NATIONAL HARBOR, MD. ' Arthrodesis is a safe procedure for midfoot arthritis, with an excellent union rate and high patient satisfaction, according to findings in a small, retrospective study.

Union was achieved in 92% of 104 feet after the primary operation, and fusion after revision was achieved in 99%. In addition, most of the patients (90%) were satisfied with the results of their procedures, reported Dr. Scott A. Nemec.

Patients included in the study had primary midfoot arthritis with or without radiologic or clinical arch collapse. The researchers identified 95 patients (104 feet) who had undergone arthrodesis. Most were women and their mean age was 61 years. The primary indication for surgery was disabling foot pain that was not relieved by other measures. On radiograph, pre-and postoperative measurements were made of the anteroposterior talus and first metatarsal angle, the lateral talus and first metatarsal angle, the medial cuneiform height, and the talonavicular uncoverage.

Other outcomes included complications and reoperations, the AOFAS midfoot score, the visual analog scale pain score (0-10), and patient satisfaction.

In all, 297 joints were fused – roughly 3 per patient. Gastrocnemius recession was performed in 80% of the feet, and 56% had a forefoot procedure. In terms of bone grafts used, autograft was used in 91% of the feet, allograft in 4%, and no grafts were used for 5%. The most commonly fused joints were the first, second, and third tarsometatarsals and the naviculocuneiform. No further surgery was required for one asymptomatic third TMT nonunion. One delayed union was consolidated with immobilization. Radiographically, improvement was seen in all parameters.

Major complications included three deep infections and one instance of chronic pain. The infections were treated with debridement. The patient with chronic pain was referred to a pain clinic.

There were 11 reoperations—7 for refusion, 3 for debridement, and 1 gastrocnemius recession. Four of the refusion patients and one debridement patient were not satisfied with their results. Hardware removal was required for a quarter of the feet at an average of 20 months, said Dr. Nemec, who is an orthopedic specialist in private practice in Petoskey, Mich.

Patient-reported outcome data were available for 68 patients (74 feet), with a mean follow-up of 56 months. The visual analog scale pain score dropped by a significant average of 4.6 points after surgery. The AOFAS score increased by a significant 47 points (maximum 100).