Retrospective Comparison of Return to Sports and Physical Activity After Forefoot and Midfoot Arthrodesis Procedures in Foot and Ankle Surgery

BackgroundPhysical activity and returning to sports are vital for athletes after foot and ankle surgery. While joint preservation is preferred, joint arthrodesis becomes necessary in certain injuries or deformities. Common procedures include Lisfranc arthrodesis, modified Lapidus for hallux valgus (HV), and first metatarsophalangeal (MTP) arthrodesis for hallux rigidus (HR), addressing pain and deformities. Prior studies show promising outcomes individually, yet lack comparisons. Thus, this retrospective study aims to compare clinical outcomes and return to sports in the 3 procedure groups.MethodsBetween 2006 and 2014, a total of 48 modified Lapidus procedures for HV, 38 Lisfranc injuries, and 50 MTP fusion for HR cases were assessed regarding their physical activity and return to sport, utilizing sports-specific, patient-administered questionnaires. Clinical outcomes were evaluated through the Foot and Ankle Outcome Score (FAOS), encompassing pain, symptoms, stiffness, daily function, sports function, and quality of life. Comparisons between these groups were made based on these survey outcomes.ResultsRegarding FAOS scores, the 3 surgery groups revealed no significant differences in outcomes for the Pain subscale (P = .07). However, significant differences were observed among the 3 groups in each of the other domains (all P < .05). These differences were due to the MTP fusion having poorer FAOS scores as the Lisfranc and Lapidus groups had no differences in all domains (all P > .05). The MTP Fusion group showed comparable outcomes regarding return to sports and physical activity despite the lower FAOS scores.ConclusionMTP Fusion patients exhibited poorer FAOS scores compared with those undergoing modified Lapidus and Lisfranc procedures. However, despite this disparity they demonstrated a high rate of return to sports suggesting that alongside partial midfoot arthrodesis for Lisfranc injuries and modified Lapidus procedure for HV, first MTP joint arthrodesis for HR represents a reliable option for young athletes.Level of Evidence:Level III, comparative series.