Multi centre service evaluation of the Roto-glide 1st MTP joint replacement

P. Laing, R. Limaye, C. Walker, S. Kendall, P. Mackennie, A. Adedapo, D. Lavalette, M. Al-Maiyah

Introduction: Joint replacement in the 1st mtp joint remains controversial as 1st mtpj fusion yields good results but at the expense of a stiff joint. 1st mtpj replacement continues to be developed and has a place for patients who wish to retain movement and for the difficult problem of dual arthritis of the ipj and mtpj. The Roto-glide is a cementless 3 component titanium HA coated device which was developed in Denmark and has been in use there for over 14 years with reported good results.

Methods: New devices should be evaluated in controlled trials so, prior to introduction into the UK, a prospective multi centre service evaluation audit was set up with a defined protocol, registered in Oswestry and conducted in 6 centres around the UK. The results of 43 Roto-glides in 43 patients, with a minimum follow up of one year, are presented.

Results: There were 14 male and 29 female patients. The minimum age was 45 and maximum 80 years with an average of 59.6 years. Follow up was from 12-29 months with an average of 16.9 months. The pre-operative AOFAS scores ranged from 17 to 67 with an average of 39.5. The post operative AOFAS scores ranged from 29 to 100 with an average of 77. Post operatively one patient developed a superficial wound infection, one developed medial sesamoiditis and one developed a 1st metatarsal stress fracture at 18 months which healed with non operative treatment. No loosenings have been seen and no revisions performed. A satisfactory post operative range of movement was obtained by ensuring the components were not put in tight and mobilising the joint early and regularly.

Conclusion: The early results encourage the longer term evaluation of the prosthesis.