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toes Swanson Implant Arthroplasty for Hallux Valgus in Older Patients

Discussion in 'Other Joints Library' started by Josephine, May 4, 2016.

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  1. Josephine

    Josephine FORUM ADMIN, DIRECTOR Administrator
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    Swanson Implant Arthroplasty for Hallux Valgus in Elder Patients POSTER NO. P063
    Koh Shimizu, MD, Chiba, Japan
    Sara Shimizu, MD, Chiba, Japan


    INTRODUCTION: Various surgical methods have been reported for hallux valgus with sufficient results; however, several weeks are necessary for patients to walk by full weight bearing after any osteotomy due to the risk of fracture and dislocation. Contrarily, it is possible for the patients to walk immediately after Swanson implant arthroplasty, although there are a few reports which describe its results in detail. The purpose of this study is to investigate the results of Swanson implant arthroplasty for hallux valgus in elder patients, by analyzing the clinical symptoms and X-ray findings including hallux valgus angle and intermetatarsal angle.

    METHODS: Analysis of 118 cases of Swanson implant arthroplasty in 75 patients was performed. There were eight male and 67 female, and all the patients were older than 60 years and average age was 73 years old. Swanson implant arthroplasty were performed by one surgeon (K.S.) with additional soft tissue release and tightening of medial capsule. All the patients were followed clinically more than five years postoperatively with mean follow up period of 103 months. Radiographycally, hallux valgus angle and metatarsal valus angle were measured, and bone absorption and position of the implant were checked in detail at 0, 1, 3, 6, 12, 36, 60 months postoperatively and at most recent examination.

    RESULTS: 1. Pain decreased significantly after surgery and good condition continued until the most recent examination in all the cases but one. 2. Average hallux valgus angle, which was 52° preoperatively, changed to 3° immediately after operation, 9° at three months postoperatively, and 12° at most recent examination. 3. Average intermetatarsal angle, which was 29° preoperatively, changed to 6° immediately after operation, 8° at 3=three months postoperatively, and 9° at most recent examination. 4. There were no cases with infection, skin necrosis, or sensory disturbance, although bone absorption around the implant was revealed in one case.

    DISCUSSION AND CONCLUSION: These results indicate that Swanson implant arthroplasty was very effective to reduce pain and correct deformity in most patients with hallux valgus. The best indication of this surgery is believed to be relatively elder patients who hope for a quick return to normal daily activity, although their activity is not as high as younger ones, considering permanence of the implant.
     
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