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Outcomes of Joint-Preserving Surgery for Forefoot Deformities in Patients With Rheumatoid Arthritis.
Tominaga, Ayako; Ikari, Katsunori; Yamada, Akifumi; Yano, Koichiro; Okazaki, Ken.
Afiliación
  • Tominaga A; Department of Orthopedic Surgery, Tokyo Women's Medical University, Tokyo, Japan.
  • Ikari K; Department of Orthopedic Surgery, Tokyo Women's Medical University, Tokyo, Japan.
  • Yamada A; Institute of Rheumatology, Tokyo Women's Medical University Hospital, Tokyo, Japan.
  • Yano K; Division of Multidisciplinary Management of Rheumatic Diseases, Tokyo Women's Medical University, Tokyo, Japan.
  • Okazaki K; Department of Orthopedic Surgery, Tokyo Women's Medical University, Tokyo, Japan.
Foot Ankle Int ; 45(3): 261-271, 2024 Mar.
Article en En | MEDLINE | ID: mdl-38327241
ABSTRACT

BACKGROUND:

With the advent of effective disease-modifying medications, the surgical treatment of forefoot deformities in patients with rheumatoid arthritis (RA) has evolved from joint-sacrificing to joint-preserving surgery. However, it is unclear whether joint-preserving surgery is effective for the full range of metatarsophalangeal joint involvement. Hence, this study investigated the postoperative outcomes of joint-preserving surgery for rheumatoid forefoot deformities with a wide range of joint destruction.

METHODS:

This retrospective observational study included 68 feet from 68 patients with RA who underwent joint-preserving surgery for forefoot deformities between 2014 and 2020. The Larsen grade classification was used to assess the first metatarsophalangeal joint destruction and classify patients into 4 groups as follows 0 and 1 (n = 14), 2 (n = 21), 3 (n = 19), and 4 and 5 (n = 14). The Self-Administered Foot and Ankle Evaluation Questionnaire (SAFE-Q) score, hallux valgus angle (HVA), and intermetatarsal angle (IMA) were determined before surgery and at the last follow-up visit.

RESULTS:

The median observation duration was 40 (range, 24-78) months. SAFE-Q scores of all groups significantly improved in all subscales at the last observation, with no significant differences among the study groups. Radiographic evaluations of all groups revealed significant improvements in HVA and IMA after surgery, with no significant differences among the groups.

CONCLUSION:

In patients using the surgical approaches described in this study, joint-preserving surgery for rheumatoid forefoot deformities led to satisfactory clinical and radiographic improvements, regardless of the severity of joint destruction. LEVEL OF EVIDENCE Level III, case-control study.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artritis Reumatoide / Hallux Valgus / Juanete / Articulación Metatarsofalángica Tipo de estudio: Observational_studies Límite: Humans Idioma: En Revista: Foot Ankle Int Asunto de la revista: ORTOPEDIA Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artritis Reumatoide / Hallux Valgus / Juanete / Articulación Metatarsofalángica Tipo de estudio: Observational_studies Límite: Humans Idioma: En Revista: Foot Ankle Int Asunto de la revista: ORTOPEDIA Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Estados Unidos