Surgical treatment of injuries and damages of the hallucal sesamoid complex using arthroscopic technique

Purpose: To evaluate the clinical outcomes and postoperative complications of partial resection of the medial sesamoid bone by arthroscopic method. Materials and methods: The present case series included 16 patients who underwent arthroscopic partial resection of the sesamoid. Preoperative evaluation included a complete medical history, physical examination using a passive axial compression test, radiographic evaluation, MRI, and CT. Postoperative complications, level of activity, number of days required for daily return to normal life were recorded; for athletes, the ability to return to sports and the level of postoperative athletic performance; for dancers, the ability to return to professional activities. Pre- and postoperative pain was assessed using a visual analogue scale. Outcome measures were assessed using the American Orthopedic Foot and Ankle Society (AOFAS) clinical rating scale. Result: According to the postoperative assessment at the end of the observation period, the VAS scores improved compared to the preoperative level from 6.1±1.1 (range: 5-8) to 0.9±0.9 (range: 0-3). AOFAS scores preoperatively averaged 54.3 ± 7.2 (range: 44–66) and improved to 90.8 ± 7.7 (range: 78–100) postoperatively. The mean duration to return to activity was 6.3 ± 2.7 months (range: 2–12 months). All 8 athletes returned to active sports after an average of 5.8 ± 2.8 months (range: 2-10 months). However, two patients had not achieved pre-injury athletic performance at the end of the follow-up period. Conclusion: Partial resection of the medial sesamoid bone by arthroscopic method is an effective and reliable treatment for osteoarthritis of metatarsomesamoid complex, but further comparative studies of the results of open and arthroscopic procedures are needed.