Patients who undergo isolated fibular sesamoidectomy report long-term pain relief
CHICAGO — At long-term follow-up, patients with sesamoiditis, fracture, nonunion, osteonecrosis and arthritis who underwent isolated fibular sesamoidectomy reported long-term pain relief, according to a presenter at the American Orthopaedic Foot and Ankle Society Annual Meeting.
“Since there is literally no research on this published, this hopefully helps us guide our discussions with patients about whether or not to pursue a sesamoidectomy,” Samuel E. Ford, MD, said during his presentation. “Again, we did not decrease in hallux flexion strength, a change in hallux alignment or deterioration of patient satisfaction over time.”
Using CPT code 28135, Ford and colleagues identified 92 patients who underwent isolated fibular sesamoidectomy. Treating physicians contacted patients who underwent an isolated fibular sesamoidectomy with a recruitment letter, phone calls or email to return for an office visit. The median follow-up was 60 months. The preoperative to final postoperative change in the VAS pain score was the primary outcome measure. Other measures included satisfaction, hallux flexion strength, change in hallux alignment and final postoperative function scores.
There were 35 patients who underwent 36 sesamoidectomy and had minimum 2-year clinical or radiographic follow-up. Investigators noted that at the final follow-up, the median VAS score improved from 6 to 1. There were no significant differences seen between preoperative and postoperative values with regard to the final postoperative hallux valgus angle and the intermetatarsal angle.
Investigators found 88% of patients said they would have the surgery again. Seventy percent of patients who were “very satisfied” with their postoperative results. After sesamoidectomy, hallux flexion strength was not different compared with the contralateral foot. Overall, three of the 92 patients underwent reoperations. – by Monica Jaramillo
Ford S, et al. Long-term outcomes and alignment following isolated fibular sesamoidectomy. Presented at: American Orthopaedic Foot and Ankle Society Annual Meeting; Sept. 12-15, 2019; Chicago.
Disclosure: Ford reports no relevant financial disclosures.