Mid-term outcomes of first metatarsophalangeal arthroplasty using the Primus FGT double-stemmed silicone implants.

ABSTRACT

BACKGROUND: Silicone implants for first metatarsophalangeal (MTP-1) arthroplasty are regaining popularity, though most studies have long inclusion periods, or short follow-up. The authors aimed to report mid-term outcomes of a cohort that received a third-generation MTP-1 implant at minimum follow-up of 5 years. METHODS: The authors evaluated 70 MTP-1 arthroplasties performed in 64 patients using the Primus™ Flexible Great Toe implant. The indications were hallux rigidus of grade II (10%) and grade III (87.1%) or revision surgery (2.9%). RESULTS: All patients completed clinical and radiographic assessments at 83.5 months (range, 62-114). There were no revisions or reoperations and the AOFAS-HMI score was 88.9±9.1 (median, 90; range, 67-100). Metatarsalgia was 'absent' in 47.1%, 'mild' in 41.1%, 'moderate' in 7.1% and 'severe' in 1.4%. CONCLUSION: This study reported excellent mid-term clinical outcomes and survival rates of a third generation MTP-1 arthroplasty design and confirmed findings of recent studies regarding efficacy of silicone double-stemmed implants. LEVEL OF EVIDENCE Level IV case series.