Aug 26, 2026 · 25 min · 7 segments
In this special episode hosted by the AOFAS Young Physicians Committee and EFAS Youth Committee, AOFAS surgeons Matt Conti, MD, and Sara Galli, MD, join EFAS surgeons Amit Patel, MBBS, BSc, MSc FRCS…
Amit PatelHost
Sara GalliGuest
Matt ContiGuestTom LewisGuest
Good morning slash good afternoon to, or good night, depending on where our listeners are joining us from.
So the paper I was assigned was a JBJS article that was kind of written as a response to the original motion trial for the polyvinyl hydrogel implant that came on the market, and it was there to follow up as a non-industry sponsored study.
The reason I picked this article was less to do with looking at that implant, but more just looking at outcomes from hallux rigidus treatment with arthrodesis.
I don't know if it's my patient population in a farming region or what, but, you know, I'm doing a lot more arthrodesis than I am the other treatments.
And so my bias was picking a paper that kind of challenged me on am I doing the right thing for my patient, but also hopefully proves that I am doing the right thing for my patients.
They looked back at all the patients that had either the implant versus an MTP fusion and had at least two years of PROMIS data follow-up.
This institution that did this did have computer adaptive testing of their PROMIS data, so it allowed them to collect a lot of data points without kind of getting survey fatigue of their patients.
They looked at their preoperative demographics and the cohorts, which were pretty big.
It's the largest series I've seen of this implant for sure, other than the level one study.
And interestingly, the preoperative grade of their hallux rigidus graded according to Coughlin was actually reasonably similarly distributed, and there wasn't a significant difference there.
It took me a minute to dissect it as I was looking at it, but essentially what they high level found is, and interestingly, not a significant difference between a resurfacing implant or hallux MTP fusion in this series.
And so what they did with their study is they defined five points of PROMIS as different.
And so basically all of these significant scores indicates that there is not a significant difference.
And so the fact that there's so many significant P values is indicating no difference in this study, except for in a couple little places, which we'll talk about in just a second.
So very high level, most of the PROMIS scores tested did not indicate a significant difference at two years, with the exception being pain interference.
And so pain interference did demonstrate a slight favor in lieu of arthrodesis, that it had more complete pain relief compared to the resurfacing implant.
This was interesting because the author's hypothesis was that, yes, pain might be a little better in the arthrodesis group, but the authors also thought that function would be a little higher in the resurfacing group due to retained motion, and that did not play out in their data, is that they were equivalent.
Good morning slash good afternoon to, or good night, depending on where our listeners are joining us from.
So the paper I was assigned was a JBJS article that was kind of written as a response to the original motion trial for the polyvinyl hydrogel implant that came on the market, and it was there to follow up as a non-industry sponsored study.
The reason I picked this article was less to do with looking at that implant, but more just looking at outcomes from hallux rigidus treatment with arthrodesis.
I don't know if it's my patient population in a farming region or what, but, you know, I'm doing a lot more arthrodesis than I am the other treatments.
And so my bias was picking a paper that kind of challenged me on am I doing the right thing for my patient, but also hopefully proves that I am doing the right thing for my patients.
They looked back at all the patients that had either the implant versus an MTP fusion and had at least two years of PROMIS data follow-up.
This institution that did this did have computer adaptive testing of their PROMIS data, so it allowed them to collect a lot of data points without kind of getting survey fatigue of their patients.
They looked at their preoperative demographics and the cohorts, which were pretty big.
It's the largest series I've seen of this implant for sure, other than the level one study.
And interestingly, the preoperative grade of their hallux rigidus graded according to Coughlin was actually reasonably similarly distributed, and there wasn't a significant difference there.
It took me a minute to dissect it as I was looking at it, but essentially what they high level found is, and interestingly, not a significant difference between a resurfacing implant or hallux MTP fusion in this series.
And so what they did with their study is they defined five points of PROMIS as different.
And so basically all of these significant scores indicates that there is not a significant difference.
And so the fact that there's so many significant P values is indicating no difference in this study, except for in a couple little places, which we'll talk about in just a second.
So very high level, most of the PROMIS scores tested did not indicate a significant difference at two years, with the exception being pain interference.
And so pain interference did demonstrate a slight favor in lieu of arthrodesis, that it had more complete pain relief compared to the resurfacing implant.
This was interesting because the author's hypothesis was that, yes, pain might be a little better in the arthrodesis group, but the authors also thought that function would be a little higher in the resurfacing group due to retained motion, and that did not play out in their data, is that they were equivalent.
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