Hemiendoprosthetics of the metatarsophalangeal joints in osteochondropathy of the metatarsal head (Freiberg-Keller II disease)

Among osteochondropathy, intra-articular osteochondropathy, including osteochondropathy of the metatarsal heads or Freiberg's (Keller's II) disease, can be considered unfavorable prognostically due to the intra-articular localization of aseptic necrosis. One of the promising methods of treating this pathology is endoprosthesis replacement, however, there are not enough data in the literature on the results of its use. The purpose of the study was to evaluate the results of metatarsophalangeal joint arthroplasty with ceramic hemiendoprostheses. Materials and methods. The results of arthroplasty in 8 patients (all women, mean age 36 years) with Moje implants using Pressfit technology were evaluated: the level of physical activity according to the ODA23+ scale, AOFAS scores, radiographs, patient satisfaction with the treatment for periods of 3 months up to 2 years. Results. The level ofphysical activity was regarded as high in 62.5%, low - in 37.5% of patients. The mean value on the AOFAS scale before surgery was 55.3 points; after 3 months - 91.4; after 6 months - 95.1; after 1 year and in the second year of observation - 96.1 points. In none of the cases, 2 years after the operation, radiographic signs of endoprosthesis instability were detected. Satisfaction with the treatment was noted by 100% of operated patients. Conclusions. Hemiarthroplasty of the second, third and fourth metatarsophalangeal joints with ceramic implants is a fast and effective way to restore function and eliminate anatomical defects of the small ray heads on the foot. Good short- and medium-term results allow expanding the indications for the use of the arthroplasty method in the surgical treatment of this pathology.