Outcomes of Scarf and Akin Osteotomy with Intra-Articular Stepwise Lateral Soft Tissue Release for Correcting Hallux Valgus Deformity in Rheumatoid Arthritis

Takumi Matsumoto, Yuji Maenohara, Song Ho Chang, Kumiko Ono, Yasunori Omata, Jun Hirose and Sakae Tanaka
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Takumi Matsumoto: Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan
Yuji Maenohara: Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan
Song Ho Chang: Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan
Kumiko Ono: Department of Joint Surgery, Research Hospital, The Institute of Medical Science, The University of Tokyo, Minato-ku, Tokyo 108-8639, Japan
Yasunori Omata: Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan
Jun Hirose: JCHO Tokyo Shinjuku Medical Center, Department of Orthopaedic Surgery, Shinjuku-ku, Tokyo 162-8543, Japan
Sakae Tanaka: Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan

IJERPH, 2021, vol. 18, issue 20, 1-13

Abstract: Background. The effectiveness of scarf and Akin osteotomy with intra-articular lateral soft tissue release for the correction of hallux valgus (HV) in patients with rheumatoid arthritis (RA) has not been elucidated. Methods. A total of 36 feet in 28 patients with RA who had scarf and Akin osteotomy with intra-articular stepwise lateral soft tissue release between 2015 and 2020 at a single institute were investigated retrospectively, with a mean follow-up period of 32.0 ± 16.9 months. Radiographic evaluations including the HV angle, intermetatarsal angle, and sesamoid position were performed preoperatively and postoperatively. Clinical outcomes were assessed using the Japanese Society of Surgery of the Foot (JSSF) hallux scale and self-administered foot evaluation questionnaire (SAFE-Q). Results. The procedure resulted in significant HV correction, with a recurrence rate of 13.9%. The JSSF scale and all five SAFE-Q subscale scores significantly improved ( p < 0.05), with no major complications. More than 90% of cases achieved adequate lateral soft tissue release without sacrificing the adductor tendon of the hallux. Conclusions. Intra-articular stepwise lateral soft tissue release in combination with scarf and Akin osteotomy provided satisfactory radiographic and patient-reported outcomes for the correction of HV in patients with RA with minimum lateral soft tissue release.

Keywords: akin osteotomy; hallux valgus; intra-articular release; joint-preserving arthroplasty; lateral soft tissue release; metatarsosesamoid suspensory ligament; rheumatoid arthritis; scarf osteotomy (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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