Journal article
Is adjunction of advanced platelet-rich fibrin (A-PRF) useful in first metatarsophalangeal joint arthrodesis? A retrospective cohort study
Foot (Edinburgh, Scotland), Vol.42, pp.101648-101648
03/2020
DOI: 10.1016/j.foot.2019.10.003
PMID: 32035404
Abstract
•First metatarsophalangeal joint arthrodesis proved effective in the treatment of end-stage hallux rigidus.•The adjunction of A-PRF may accelerate the fusion in order to gain consolidation over the first 6 weeks after surgery.•Clinical assessment at two years has revealed excellent results after joint fusion both with and without A-PRF.•No complication or increased morbidity was reported by patients treated with A-PRF.
First metatarsophalangeal (MTPJ1) fusion represents the gold standard treatment for end-stage hallux rigidus (HR). The aim of this study was to assess efficacy and safety of A-PRF in promoting union after MTPJ1 arthrodesis. Our hypothesis was that the use of A-PRF may reduce the non-union rate and the time to fusion in the treatment of HR.
14 patients that had undergone MTPJ1 arthrodesis with A-PRF adjunction with 21 standard MTPJ1 fusions were retrospectively reviewed. The fusion rate and time to fusion (clinically and radiographically) were assessed at 6, 12 weeks and at the longest follow-up; the clinical status at final follow-up through forefoot AOFAS, EQ5d, SEFAS and VAS-pain scores; the complication rate.
At 6-weeks, bony union was achieved in 100% of patients in the A-PRF group compared to 70% in the control group, but this difference was not statistically significant (p=0.22). At final follow-up (41 months), union rate in the control group reached 92% (one non-union). AOFAS, VAS and EQ-5d scores showed similar results for the two groups (p=0.86, p=0.12 and p=0.61, respectively); only SEFAS score revealed a difference favoring the A-PRF group (p=0.04). No revision surgery or complication was recorded in any group.
A tendency for increased union rate was mainly found at 6 weeks in patients treated with MTPJ1 fusion associated to A-PRF compared to isolated fusion. The use of A-PRF was not associated with an increased complication rate at final follow-up.
Level 3, therapeutic study, retrospective comparative study.
Details
- Title: Subtitle
- Is adjunction of advanced platelet-rich fibrin (A-PRF) useful in first metatarsophalangeal joint arthrodesis? A retrospective cohort study
- Creators
- Alessio Bernasconi - Royal National Orthopaedic HospitalJulien Cailliez - Hôpital Paule de ViguierCesar de Cesar Netto - University of IowaMatthieu Wargny - Centre Hospitalier Universitaire de NantesNazim Mehdi - Clinique de l'Union, Centre de Chirurgie de la cheville et du pied, Saint-Jean, FranceJean Alain Colombier - Clinique de l'Union, Centre de Chirurgie de la cheville et du pied, Saint-Jean, FranceFrançois Lintz - Clinique de l'Union, Centre de Chirurgie de la cheville et du pied, Saint-Jean, France
- Resource Type
- Journal article
- Publication Details
- Foot (Edinburgh, Scotland), Vol.42, pp.101648-101648
- DOI
- 10.1016/j.foot.2019.10.003
- PMID
- 32035404
- NLM abbreviation
- Foot (Edinb)
- ISSN
- 0958-2592
- eISSN
- 1532-2963
- Publisher
- Elsevier Ltd
- Language
- English
- Date published
- 03/2020
- Academic Unit
- Orthopedics and Rehabilitation
- Record Identifier
- 9984304680802771
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