Saravana Vail Karuppiah
University Hospital of South Manchester NHS Foundation Trust, UKPresentation Title:
Retrospective study comparing plating and minimally invasive surgery for first metatarsophalangeal fusion
Abstract
Aim of the Study:
First metatarsophalangeal (MTP) joint arthritis is a common cause of foot pain and disability, and surgical intervention is often necessary when conservative treatments fail. This comparative retrospective study aimed to evaluate the clinical outcomes and complications of Plating and Minimally Invasive Surgery (MIS) techniques for 1st Metatarsophalangeal (MTP) fusion in a smaller cohort of 79 patients, of which 24 had Plating and 55 had MIS.
Method:
A retrospective analysis of medical records was performed on 79 patients who underwent 1st MTP fusion using either Plating (n=24) or MIS (n=55) technique performed within the last 5 years at the Nottingham city hospital. The primary outcomes were pain reduction, functional outcome, radiological fusion rate, clinical fusion, and complications.
Results:
The results showed that both Plating and MIS groups were effective in achieving 1st MTP fusion. Both groups showed significant improvement in pain reduction and functional outcomes. The MIS group had a shorter operation time ( 86.13 vs. 92.91 minutes), fewer complications (26.67% vs. 17.39%) and faster return to normal activities compared to the Plating group. Plating, on the other hand, was associated with a lower incidence of revision surgery. However, there were no statistically significant differences in the radiological fusion rate between the two groups.
Conclusion:
The results of this smaller cohort study indicate that both Plating and MIS techniques are effective for 1st MTP fusion. However, MIS technique resulted in fewer complications, shorter operation time and faster return to normal activities, although further research with larger sample size is needed to determine whether these differences are statistically significant. Plating may be associated with a lower incidence of revision surgery, which may be a consideration in certain cases.
Keywords: Plating, Minimally Invasive Surgery, First Metatarsophalangeal fusion
Biography
Mr Vail Karuppiah is a leading consultant orthopaedic surgeon based in Nottingham who specialises in foot and ankle surgery. His specialities are minimally-invasive bunion surgery, first MTP joint replacement and adult-acquired flat foot as well as ankle replacement, keyhole surgery for plantar fasciitis and foot and ankle deformity correction. He privately practices at the Woodthorpe Hospital, Nottingham, and his NHS base in Nottingham University Hospital NHS Trust. Mr Karuppiah, who is the only surgeon to offer minimally-invasive surgery to treat bunions in East Midlands region, advocates for individualised surgery and professional care for his patients. He uses keyhole surgery for the management of bunion correction and believes that the advantages of this procedure allows for patients' early recovery. Furthermore, they have signifcantly less time off work and fewer complications.
Mr Karuppiah's practice takes a holistic approach where surgery is just one part of what's required for patients to regain their quality of life. His subspecialties also include rheumatoid foot and ankle, diabetic foot and tendo-achilles treatment as well as ankle ligament reconstruction, ankle arthroscopy and big toe arthritis (Hallux Rigidus). Mr Karuppiah has an MBBS in Medicine from the Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) and went on to begin his surgical career in Scotland. He completed his further training on the National Orthopaedic Training Programme in the East Midlands, working at various hospitals including the Queen's Medical Centre in Nottingham, University Hospitals of Derby and Burton and King's Mill Hospital, Mansfield. He also did international fellowships in South Africa and Australia. Complementing Mr Karrupiah's clinical practice and educational history, he has an esteemed teaching and academic research career. He was a clinical tutor at the University of Aberdeen, has had his work published in respected international journals and regularly organises and presents at national and international seminars.
He is a fellow (FRCS) of the Royal College of Surgeons Edinburgh and also a member of the esteemed organisation (MRCS), alongside the British Orthopaedic Foot and Ankle Society (BOFAS), British Orthopaedic Association (BOA) and the British Medical Association (BMA).
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