Polyvinyl alcohol hydrogel implant for the treatment of hallux rigidus is associated with a high complication rate and moderate failure rate at short-term follow-up: a systematic review

被引:1
|
作者
Butler, James J. [1 ]
Dhillon, Ravneet [2 ]
Wingo, Taylor [1 ]
Lin, Charles C. [1 ]
Samsonov, Alan P. [1 ]
Azam, Mohammad T. [1 ]
Kennedy, John G. [1 ]
机构
[1] NYU Langone Hlth, Dept Orthopaed Surg, Foot & Ankle Div, 171 Delancey St, 2nd Floor, New York, NY 10002 USA
[2] Royal Coll Surgeons Ireland, Dublin, Ireland
来源
EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY | 2024年 / 34卷 / 04期
关键词
Polyvinyl alcohol hydrogel; Synthetic cartilage implant; Hallux rigidus; 1ST METATARSOPHALANGEAL JOINT; SYNTHETIC CARTILAGE IMPLANT; ARTHRODESIS; HEMIARTHROPLASTY; MOTION;
D O I
10.1007/s00590-024-03895-w
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
PurposeModerate-to-severe hallux rigidus is a debilitating pathology that is optimally treated with surgical intervention. Arthrodesis produces reliable clinical outcomes but is limited by restriction in 1st metatarsophalangeal joint range of motion. The advent of polyvinyl alcohol hydrogel (PVA) implants have produced early promise based on initial trials, but more recent studies have called into question the efficacy of this procedure. The purpose of this systematic review was to evaluate the clinical and radiological outcomes following the use of PVA for hallux rigidus.MethodsThe MEDLINE, EMBASE and Cochrane library databases were systematically reviewed using the preferred reporting items for systematic reviews and meta-analyses guidelines. 18 studies were included.ResultsIn total, 1349 patients (1367 feet) underwent PVA at a weighted mean follow-up of 24.1 +/- 11.1 months. There were 168 patients (169 feet) included in the cheilectomy cohort and 322 patients (322 feet) included in the arthrodesis cohort. All 3 cohorts produced comparable improvements in subjective clinical outcomes. Postoperative imaging findings in the PVA cohort included joint space narrowing, peri-implant fluid, peri-implant edema and erosion of the proximal phalanx. The complication rate in the PVA cohort, cheilectomy cohort and arthrodesis cohort was 27.9%, 11.8% and 24.1%, respectively. The failure rates in the PVA cohort, cheilectomy cohort and arthrodesis cohort was 14.8%, 0.3% and 9.0%, respectively.ConclusionThis systematic review demonstrated that PVA produced a high complication rate (27.9%) together with concerning postoperative imaging findings at short-term follow-up. In addition, a moderate failure rate (14.8%) and secondary surgical procedure rate (9.5%) was noted for the PVA cohort. The findings of this review calls into question the efficacy and safety of PVA for the treatment of hallux rigidus.Level of evidence: IV.ConclusionThis systematic review demonstrated that PVA produced a high complication rate (27.9%) together with concerning postoperative imaging findings at short-term follow-up. In addition, a moderate failure rate (14.8%) and secondary surgical procedure rate (9.5%) was noted for the PVA cohort. The findings of this review calls into question the efficacy and safety of PVA for the treatment of hallux rigidus.Level of evidence: IV.
引用
收藏
页码:1765 / 1778
页数:14
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