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Clinical outcomes of first metatarsophalangeal joint prosthesis PH-Flex Medin and its effect on the biomechanics of the forefoot in the propulsion phase of the gait cycle
Popelka, Stanislav ; Hromádka, Rastislav (advisor) ; Krbec, Martin (referee) ; Holinka, Martin (referee)
The dissertation evaluates the results of a first metatarsophalangeal (MTP) joint replacement. The PH-Flex MTP joint replacement was developed at the 1st Department of Orthopaedics, the first faculty of medicine in conjunction with the Medin s.r.o. company. The clinical trials ran between 2007 and 2011. Between 2011 and 2016, the implant was used in clinical practice, where the indication criteria of its use were gradually adjusted. This work summarises publications originating in our department, evaluating the 5-year period during which the implant was used and the results of its use. In the first part of the dissertation, we present the retrospective study evaluating a group of 31 patients after the implantation of 35 MTP joint replacements was published in 2017. Bilateral surgery was performed on 4 patients. A minimum follow-up of 6 months was required for inclusion in the study. In 30 cases, the indication was 1st MTP joint arthritis of grades 3 and 4 according to the Coughlin classification. A conversion from hemiarthroplasty to total arthroplasty was performed in 4 patients, and in 1 case, the surgery was performed as a revision from a failed silastic 1st MTP joint replacement. The evaluation was performed not only radiographically but also according to the American Orthopaedic Foot and Ankle...
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