Surgical management of osteochondral lesions of the first metatarsal head: A systematic review.
First metatarsal head
Hallux rigidus
Osteochondral autograft
Osteochondral lesions
Osteochondritis dissecans
Journal
Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons
ISSN: 1460-9584
Titre abrégé: Foot Ankle Surg
Pays: France
ID NLM: 9609647
Informations de publication
Date de publication:
Jul 2023
Jul 2023
Historique:
received:
28
03
2023
revised:
05
05
2023
accepted:
26
05
2023
medline:
5
7
2023
pubmed:
11
6
2023
entrez:
10
6
2023
Statut:
ppublish
Résumé
Treating osteochondral lesions of the first metatarsal head can help reducing pain and preventing end-stage arthritic cartilage degeneration and hallux rigidus. Several surgical techniques have been described, but no clear indications are reported. This systematic review aims to offer an overview of the current surgical treatments for focal osteochondral lesions of the first metatarsal head. The selected articles were examined to extract data about population, surgical technique, and clinical outcomes. Eleven articles were included. Mean age at surgery was 38,2 years. Osteochondral autograft was the most used technique. After surgery, an improvement was achieved in AOFAS, VAS, and hallux dorsiflexion but not in plantarflexion. There is limited evidence and knowledge regarding the surgical management of the first metatarsal head osteochondral lesions. Various surgical techniques have been proposed, drawn from other districts. Good clinical results have been reported. Further high-level comparative studies are necessary to design an evidence-based treatment algorithm.
Sections du résumé
BACKGROUND
BACKGROUND
Treating osteochondral lesions of the first metatarsal head can help reducing pain and preventing end-stage arthritic cartilage degeneration and hallux rigidus. Several surgical techniques have been described, but no clear indications are reported. This systematic review aims to offer an overview of the current surgical treatments for focal osteochondral lesions of the first metatarsal head.
METHODS
METHODS
The selected articles were examined to extract data about population, surgical technique, and clinical outcomes.
RESULTS
RESULTS
Eleven articles were included. Mean age at surgery was 38,2 years. Osteochondral autograft was the most used technique. After surgery, an improvement was achieved in AOFAS, VAS, and hallux dorsiflexion but not in plantarflexion.
CONCLUSION
CONCLUSIONS
There is limited evidence and knowledge regarding the surgical management of the first metatarsal head osteochondral lesions. Various surgical techniques have been proposed, drawn from other districts. Good clinical results have been reported. Further high-level comparative studies are necessary to design an evidence-based treatment algorithm.
Identifiants
pubmed: 37301674
pii: S1268-7731(23)00099-1
doi: 10.1016/j.fas.2023.05.007
pii:
doi:
Types de publication
Systematic Review
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
387-392Informations de copyright
Copyright © 2023 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest We are submitting the manuscript for publication consideration in FOOT AND ANKLE SURGERY entitled “SURGICAL MANAGEMENT OF OSTEOCHONDRAL LESIONS OF THE FIRST METATARSAL HEAD: A SYSTEMATIC REVIEW” written by Elena Artioli, Antonio Mazzotti, Simone Ottavio Zielli, Alberto Arceri, Laura Langone, Simone Gerardi, and Cesare Faldini. None of the authors has a conflict of interest that could inappropriately influence this work.