Sesamoid pain can arise from avascular necrosis, fracture, osteochondrosis, and advanced degeneration. Disorders of the sesamoids in athletes can be debilitating. Total sesamoidectomy of the involved sesamoid is considered an effective surgical treatment when conservative measures have failed. There is limited literature evaluating the outcome of sesamoidectomy in athletically active patients. Our 2-center study reports on 68 patients (70 procedures; 2 male patients were operated on both feet in separate procedures approximately 3 years apart; 41 (58.6%) tibial and 29 (41.4%) fibular sesamoidectomies; 24 males and 44 females, average age 28.4 ± 12.2 years) who underwent total sesamoidectomy from 01/2001 to 12/2019. In our cohort, the average time to return to activity (RTA) was 11.1 ± 5.1 weeks, with no statistically significant difference between gender and age, or between fibular and tibial sesamoidectomy in relation to RTA. There was a minimum follow-up of 1 year, with an average of 106.6 ± 66.6 months. The total incidence of complication rate was 5.7%. In athletes in whom conservative management has failed, sesamoidectomy is safe, and allows predictable return to their chosen sport. To our knowledge, none of the patients subsequently developed pathology to the remaining sesamoid.
Keywords: athlete; fibular sesamoid; return to activity; sesamoidectomy; tibial sesamoid.
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