![]() ![]() Studies were included if they were systematic reviews or meta-analyses reporting nonunion incidence and prevalence in foot or ankle arthrodesis procedures. Two independent reviewers selected and reviewed eligible studies. The Cochrane Library and MEDLINE were searched for relevant systematic reviews from inception to January 2022. The purpose of this systematic review and meta-analysis was to appraise and combine the available systematic reviews reporting nonunion incidence and prevalence in foot and ankle arthrodesis procedures. No funding has been received for this study. We wish to confirm that there are no known conflicts of interest associated with this publication. Future studies are needed providing higher level of evidence to prove the potential benefit of minimally invasive compared to open MTP I arthrodesis. This systematic literature review concludes that minimally invasive MTP I arthrodesis is a promising technique with comparable clinical, radiological outcome and complication rates as in open MTP I arthrodesis based on the available Level IV evidence. Outcome criteria and complications are critically reviewed in reflection of various clinical aspects in the following sections. The main finding of the current study is that minimally invasive MTP I arthrodesis is a promising alternative to open surgery. A total of 6 studies, published from March 1999 until September 2016, were included for final analysis. Detailed exertion of the inclusion and exclusion criteria are shown in Fig. Two more studies were included based on the references of the screened full text articles. After removing the duplicates and reviewing the titles and abstracts, 29 full text articles were analysed for eligibility. All relevant full text articles have been retrieved and their Search resultsĪpplying the defined keywords, a total of 447 studies were identified. The databases Google Scholar, PubMed, Scopus, EMBASE and Cochrane were systematically searched using various combinations of following keywords: “minimally invasive”, “arthroscopic”, “percutaneous”, “hallux”, “metatarsophalangeal”, “MTP”, “fusion” and “arthrodesis”. ![]() Ī systemic review of the current literature was conducted. This review was written according to the PRISMA statement. The aim of this study was to conduct a systematic literature review of clinical, radiological outcome and complications of minimally invasive MTP I arthrodesis. A further theoretical advantage is the prevention of shortening of the first ray due to bone preserving cartilage debridement compared to open techniques. Theoretical advantages of minimally invasive procedures include decreased wound healing problems, decreased infection-rate, smaller scars and faster recovery due to the less extensile soft tissue dissection performed. Literature reporting on the safety and effectiveness of minimally invasive MTP I arthrodesis remains scarce and its advantages over open surgery are still a matter of debate. Percutaneous techniques were described with the use of fluoroscopy guidance and allow for smaller incisions and less soft tissue dissection compared to open surgery. ![]() This technique is reported to be technically demanding and associated with a learning curve. With the advance of the arthroscope arthroscopy of the MTP I has been performed for various indications. īoth arthroscopic assisted and percutaneous arthrodesis of the MTP I have been described in the literature. For example, the use of arthroscopic-assisted ankle arthrodesis has proven to lower complication rates and is associated with a faster recovery and shorter time of hospitalization. Its indications were extended over time starting from arthroscopy of the ankle and subtalar joints, arthroscopic assisted arthrodesis, minimally invasive tendon surgery, tendoscopy through to arthroscopy of the metatarsophalangeal joints and minimally invasive arthrodesis of the MTP I. Minimally invasive techniques and arthroscopy have been introduced to foot surgery over a decade ago. It is considered to be the gold-standard for advanced hallux rigidus with satisfactory results and low complication and revision rates reported, ,, ].ĭifferent techniques have evolved over the time and different implants used as: compression screws, plate arthrodesis and staples, ,, , ]. If non-operative management fails, arthrodesis of the MTP I is a well-established surgical option for hallux rigidus, rigido-valgus, rheumatoid arthritis, septic arthritis or revision hallux valgus surgery. Disorders of the first ray are common in foot and ankle surgery and various pathologies can lead to degeneration and stiffness of the first metatarsophalangeal joint (MTP I). ![]()
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