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To date, no study has investigated how any of these health professionals manage people with OA of the first MTP joint, however, we recently reported that Australian general practitioners manage people with the broader definition of “foot and/or ankle OA” largely using medications. Although data is lacking for first MTP joint OA, research in people with midfoot OA show they commonly consult with podiatrists (48%), general practitioners (46%), and physical therapists (19%). This lack of research on first MTP joint OA makes it difficult for clinicians to base practice on robust evidence, and therefore, to separate effective from ineffective treatments.īefore designing clinical trials to evaluate treatments for first MTP joint OA, a logical first step is to identify assessment and treatment management strategies used by the health professionals to which patients most commonly consult. In contrast, a recent systematic review and meta-analysis found 97 RCTs for treatment of hip OA.
![mtp joints mtp joints](https://www.floridafootankle.com/wp-content/uploads/2018/09/toe-resection-arthroplasty.png)
#Mtp joints trial
There have only been three randomised clinical trials (RCTs) investigating conservative treatment for the condition and only one trial evaluating surgery.
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ĭespite its prevalence and disease burden, there is scant evidence to guide treatment of first MTP joint OA. People with the condition also experience substantial difficulties performing functional weight-bearing activities, and have significantly worse quality of life compared to those without the condition. First MTP joint OA is debilitating, with nearly three quarters of afflicted individuals describing the pain as “disabling”. The knee and hip are considered the most commonly affected lower limb joints, however recent population data showed that symptomatic radiographic OA of the first metatarsophalangeal (MTP) joint affected 7.8% of people aged over 50 years, making it as prevalent as hip OA. Osteoarthritis (OA) is a common and painful problem that causes significant disability. It is unclear whether these commonly-used strategies improve symptoms associated with first MTP joint OA. Treatment strategies differ between professions, particularly with respect to medication, orthoses and exercise. Podiatrists and physical therapists use an array of assessment and treatment approaches for people with first MTP joint OA, albeit there is limited evidence to support their clinical utility. In contrast, physical therapists used more exercise-based approaches to treatment, including exercise therapy (91% vs 34% p < 0.001), increasing general activity (70% vs 49% p < 0.01), and advice to pace activities (83% vs 48% p < 0.001). Podiatrists were more likely than physical therapists to discuss over-the-counter medication (42% vs 17% p < 0.001), prescribe orthoses (97% vs 66% p < 0.001), particularly custom orthoses (78% vs 42% p < 0.001), and provide advice on footwear (92% vs 78% p < 0.01) when treating first MTP joint OA. Assessment tests were similar between professions and included x-ray ( n = 151/164 92%), range of motion ( n = 127/141 90%), and a pain scale ( n = 78/99 79%). Two hundred respondents ( n = 113 (57%) podiatrists and n = 140 (70%) from Australia) completed the survey. Descriptive statistics were calculated and differences between professions compared using chi-square. Participants completed a bespoke online survey regarding the assessment and treatment approaches they most commonly use for patients with first MTP joint OA.
#Mtp joints professional
Potential respondents were recruited through professional representative organisations in Australia and the UK. MethodsĪ survey of podiatrists and physiotherapists was conducted. The aim of this study was to determine how podiatrists and physical therapists in Australia and the United Kingdom (UK) manage people with first MTP joint OA. There is limited research on assessment and treatment options, and the efficacy of current management strategies is unknown. First metatarsophalangeal (MTP) joint osteoarthritis (OA) is a common and painful problem that causes significant disability.