{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T04:50:53Z","timestamp":1791607853094,"version":"4.3.4"},"reference-count":47,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T00:00:00Z","timestamp":1696896000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T00:00:00Z","timestamp":1696896000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["CARTILAGE"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:p>Freiberg disease is a type of osteonecrosis of the metatarsal head that predominantly occurs in young females and adolescents, although it may occur at any age. The pathophysiology is multifactorial and may involve trauma, altered foot biomechanics, systemic disorders, and arterial insufficiency. The most typical location is the second metatarsal head, but Freiberg disease may also occur in other lesser toes. Nonoperative treatment is best applied in the early stage of the disease; if this is ineffective, surgical treatment is recommended. Currently available surgical procedures include debridement, osteotomy, osteochondral grafting, microfracture, interposition arthroplasty, implant arthroplasty, and metatarsal shortening arthroplasty. In this article, we propose a treatment algorithm for Freiberg disease based on the current literature and expert opinion.<\/jats:p>","DOI":"10.1177\/19476035231205676","type":"journal-article","created":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T08:30:31Z","timestamp":1696926631000},"page":"58-64","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":18,"title":["Evidence-Based Treatment Algorithm for Freiberg Disease"],"prefix":"10.1177","volume":"15","author":[{"given":"Ichiro","family":"Yoshimura","sequence":"first","affiliation":[{"name":"Faculty of Sports and Health Science, Fukuoka University, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masato","family":"Takao","sequence":"additional","affiliation":[{"name":"Clinical and Research Institute for Foot and Ankle Surgery, Chiba, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7498-7480","authenticated-orcid":false,"given":"Emilio","family":"Wagner","sequence":"additional","affiliation":[{"name":"Departamento de Traumatologia, Clinica Alemana-Universidad del Desarrollo, Santiago, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sjoerd","family":"Stufkens","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6849-1008","authenticated-orcid":false,"given":"Jari","family":"Dahmen","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gino M.M.J.","family":"Kerkhoffs","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Glazebrook","sequence":"additional","affiliation":[{"name":"Reconstructive Foot &amp; Ankle Surgery and Orthopedic Sports Medicine, Queen Elizabeth II Health Sciences Center, Halifax, NS, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,10,10]]},"reference":[{"issue":"158","key":"e_1_3_2_2_2","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1097\/00003086-198107000-00006","article-title":"Primary articular osteochondroses","author":"Omer GE","year":"1981","unstructured":"Omer GEJr. Primary articular osteochondroses. 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