Younger Versus Older Patients and 1st MTP Fusions — Surprising Findings

These findings might decrease your appetite for riskier motion-sparing alternatives to fusion in younger patients

What’s the Claim?

A long-term, matched-control group, retrospective study compared results after first MTP fusion in patients under the age of 50 years (mean age 43 ± 6) with those over 60 (mean age 67 ± 6), and found at a minimum of 10 years:

  • No clinically important between-group differences in pain relief, and both groups had excellent, sustained pain relief (VAS pain score of 1 of 10 in both groups at latest follow-up) as well as substantial improvement in patient-reported outcomes scores
  • No between-group differences in the frequency of revision surgery, but more hardware removal procedures were performed in the younger group (39% versus 12%)
  • The younger patients remained more active than the older patients, but the groups did not differ in terms of the ratio of patients’ actual activity levels to their desired activity levels (this metric is not validated, but I found it both clever and very helpful in this context)

How’s It Stack Up?