Painful First Metatarsal Phalangeal Joint Arthritis Treated with Percutaneous Tenotomy of the Flexor Hallucis Longus
DOI:
https://doi.org/10.12974/2313-0954.2016.03.01.3Keywords:
Arthritis first metatarsal phalangeal, tenotomy, level of evidence IV, therapeutic, retrospective.Abstract
Purpose: The purpose of this article is to describe the results of a minor percutaneous procedure that can be done in the office for patients with arthritis of the metatarsal phalangeal joint of the first toe who have not responded to non-operative treatment.
Methods: Fourteen patients had painful degenerative arthritis of the metatarsal phalangeal joint of the first toe with symptoms for 1 to 20 years. All were treated with percutaneous tenotomy of the flexor hallucis longus between December 2008 and January 2012. Sugery was performed in the office under local anesthesia.
Results: Two patients were lost to follow up. Follow up for the remaining 12 patients ranged from 16 to 53 months, an average of 38 months. Pre-op pain ranged from 6 to 10 out of 10, average 8.1/10. Post-op pain at follow up ranged from 0 to 7/10, average 2.6/10 for an average improvement of 5.5/10. Five (5/12) patients rated pain 0/10 or 1/10 at follow up. There were no infections after surgery, but one patient complained of toe numbness and another of toe weakness. All patients had improvement of pain at follow up. Three (3/12) patients had only 1/10 long term improvement in their pain; 2 had subsequent surgery. Nine (9/12) patients were satisfied with the procedure.
Conclusion: Percutaneous flexor hallucis longus tenotomy could be considered an initial percutaneous office surgical treatment for painful degenerative arthritis of the first metatarsal phalangeal joint.
