Document Detail


MOJE ceramic metatarsophalangeal arthroplasty: disappointing clinical results at two to eight years.
MedLine Citation:
PMID:  22835393     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Among the surgical treatment options for osteoarthritis of the first metatarsophalangeal joint (MTPJ) are a number of different designs of total arthroplasty, including the MOJE, a ceramic press fit arthroplasty. We present a 2- to 8-year followup of 31 procedures.
METHODS: Thirty-two MOJE arthroplasties were undertaken for painful hallux rigidus in 30 patients (nine male, 21 female) over 6 years (mean age 61.9; range, 37 to 76). At followup patients' symptoms, levels of function and radiographs were scored using SF-36, modified Kitaoka and AOFAS systems. Followup rate was 97%, with mean followup time 58 months (range, 28 to 97).
RESULTS: Mean scores were: Kitaoka 53.8 (15 to 75), AOFAS 61.3/100 (range, 18 to 100), SF-36 physical combined 48.6 (27.6 to 58.7) SF-36 mental score 52.2 (19.5 to 62.2). Sixteen showed radiological evidence of component loosening (either lucency, subsidence or both) and one radiograph revealed component fracture. Eight implants have been revised. In patients who had not undergone subsequent fusion, 15 had less than 36 degrees of movement, nine had 36 to 45 degrees, four were in the 46 to 60 range, and only one had more than 60 degrees. There were no infections.
CONCLUSION: Although previous studies have suggested favorable initial outcomes with the MOJE prosthesis, all have focused only on the early results. In our series, the reoperation rate of 26% at up to 8 years is worryingly high, especially given that 16 (52%) showed loosening. Although there appears to be a cohort of patients who have satisfactory outcomes with the MOJE, we would suggest the continued use of this implant.
Authors:
Sebastian Dawson-Bowling; Anthony Adimonye; Adam Cohen; Howard Cottam; James Ritchie; Michael Fordyce
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Foot & ankle international. / American Orthopaedic Foot and Ankle Society [and] Swiss Foot and Ankle Society     Volume:  33     ISSN:  1071-1007     ISO Abbreviation:  Foot Ankle Int     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-07-27     Completed Date:  2012-09-20     Revised Date:  2013-02-25    
Medline Journal Info:
Nlm Unique ID:  9433869     Medline TA:  Foot Ankle Int     Country:  United States    
Other Details:
Languages:  eng     Pagination:  560-4     Citation Subset:  IM    
Affiliation:
Orthopaedic Department, Tunbridge Wells Hospital, Pembury, Tunbridge Wells, Kent, UK. sebd_b@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Arthroplasty, Replacement / instrumentation*
Coated Materials, Biocompatible
Durapatite
Female
Follow-Up Studies
Hallux Rigidus / radiography,  surgery*
Humans
Joint Prosthesis*
Male
Metatarsophalangeal Joint / surgery*
Middle Aged
Prosthesis Design
Prosthesis Failure
Range of Motion, Articular
Reoperation / statistics & numerical data
Retrospective Studies
Zirconium
Chemical
Reg. No./Substance:
0/Coated Materials, Biocompatible; 1306-06-5/Durapatite; 7440-67-7/Zirconium; S38N85C5G0/zirconium oxide

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