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Bioabsorbable vs. titanium screws in first metatarsophalangeal joint arthrodesis: a pilot randomized controlled trial with 2-year follow-up.

Nikke Partio·Ville Mattila·Ville Waris·Heikki Mäenpää
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Abstract

INTRODUCTION: To assess the feasibility and preliminary clinical outcomes of bioabsorbable screw fixation in first metatarsophalangeal joint arthrodesis compared to conventional titanium screw fixation. METHODS: In this prospective pilot randomized controlled trial, 30 patients were allocated 1:1 to bioabsorbable or titanium cannulated lag screw fixation. Arthrodesis was performed using a cup-and-cone technique at two Finnish hospitals. Full weight-bearing in an orthopaedic shoe was allowed after six weeks. Outcomes included AOFAS and VA-FAS FA-VAS scores, union rates, and complications assessed at 3, 6, 12, and 24 months. RESULTS: Both groups showed significant functional improvement with no between-group differences. At 24 months, mean AOFAS scores were 89.1 (SD 2.7) in the titanium group and 90.0 (SD 0.0) in the bioabsorbable group (p = 0.23). Mean FA-VAS total scores (sum of pain, function, and complaints subscales) were 1948 (SE 59.4) in the titanium group and 1914 (SE 61.4) in the bioabsorbable group (p = 0.655). Union rate was 90% overall; nonunion occurred in one titanium and two bioabsorbable patients, all requiring revision. No implant-related complications or hardware removal surgeries were recorded. Degradation of bioabsorbable screws caused no adverse clinical or radiographic reactions. CONCLUSIONS: Bioabsorbable screws appear safe and feasible in first metatarsophalangeal joint arthrodesis, with preliminary outcomes comparable to titanium fixation. These findings support the conduct of a larger confirmatory trial. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03133039, registered 28 April 2017. https://clinicaltrials.gov/ct2/show/NCT03133039.

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HumansBone ScrewsAbsorbable ImplantsTitaniumFemaleArthrodesisMalePilot ProjectsMetatarsophalangeal JointMiddle AgedFollow-Up StudiesProspective StudiesAdultAgedTreatment OutcomeBioabsorbable implantMetatarsophalangeal jointRandomized controlled trialJournal ArticleRandomized Controlled TrialComparative Study

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Nikke Partio, Ville Mattila, Ville Waris, Heikki Mäenpää. 2026-09-09. Bioabsorbable vs. titanium screws in first metatarsophalangeal joint arthrodesis: a pilot randomized controlled trial with 2-year follow-up.. https://doi.org/10.1007/s00402-026-06501-2

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Journal Article; Randomized Controlled Trial; Comparative Study resourceAdult subjectAged subjectComparative Study subjectFemale subjectFollow-Up Studies subjectHumans subjectJournal Article subjectMale subjectMiddle Aged subjectPilot Projects subjectRandomized controlled trials study

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