Forefoot Deformities in Patients with Rheumatoid Arthritis: Mid- to Long-Term Result of Joint-Preserving Surgery in Comparison with Resection Arthroplasty

Yuya Takakubo, Yoshihiro Wanezaki, Hiroharu Oki, Yasushi Naganuma, Junichiro Shibuya, Ryusuke Honma, Akemi Suzuki, Hiroshi Satake and Michiaki Takagi
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Yuya Takakubo: Department of Orthopaedic Surgery, Faculty of Medicine, Yamagata University, Yamagata 990-9585, Japan
Yoshihiro Wanezaki: Department of Orthopaedic Surgery, Faculty of Medicine, Yamagata University, Yamagata 990-9585, Japan
Hiroharu Oki: Department of Orthopaedic Surgery, Faculty of Medicine, Yamagata University, Yamagata 990-9585, Japan
Yasushi Naganuma: Department of Orthopaedic Surgery, Faculty of Medicine, Yamagata University, Yamagata 990-9585, Japan
Junichiro Shibuya: Department of Orthopaedic Surgery, Faculty of Medicine, Yamagata University, Yamagata 990-9585, Japan
Ryusuke Honma: Department of Orthopaedic Surgery, Faculty of Medicine, Yamagata University, Yamagata 990-9585, Japan
Akemi Suzuki: Department of Orthopaedic Surgery, Faculty of Medicine, Yamagata University, Yamagata 990-9585, Japan
Hiroshi Satake: Department of Orthopaedic Surgery, Faculty of Medicine, Yamagata University, Yamagata 990-9585, Japan
Michiaki Takagi: Department of Orthopaedic Surgery, Faculty of Medicine, Yamagata University, Yamagata 990-9585, Japan

IJERPH, 2021, vol. 18, issue 21, 1-10

Abstract: Background: Joint-preserving surgery for the forefoot has been increasingly performed for rheumatoid arthritis (RA). We compared joint-preserving surgeries with resection arthroplasty for RA in the forefoot. Methods: Forefoot surgeries were performed on 62 toes in 42 patients with RA (men: 2; women: 40) between 2002 and 2018. Three groups were compared: PP—31 toes treated with joint-preserving surgery involving the modified Mann method for the big toe and offset osteotomy for lesser toes, PR—15 toes treated with joint-preserving surgery for the big toe and resection arthroplasty for lesser toes, and RR—16 toes treated with resection arthroplasty for all the toes. Results: The PP group had significantly higher mean scores on a scale for RA in the foot and ankle at the latest follow-up than the RR group (86 vs. 75 points; p < 0.05). Hallux valgus (angle > 20°) of the big toe at the latest follow-up recurred in 10 (32%), 9 (60%), and 16 (100%) patients in the PP, PR, and RR groups, respectively. A revision surgery was performed in one patient each in the PP and PR groups. Conclusions: Joint-preserving surgery is superior to resection arthroplasty in preventing function loss and the recurrence of hallux valgus.

Keywords: foot; joint-preserving surgery; rheumatoid arthritis (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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