Long-term outcome of joint-preserving surgery by combination metatarsal osteotomies for shortening for forefoot deformity in patients with rheumatoid arthritis

被引:31
|
作者
Niki, Hisateru [1 ]
Hirano, Takaaki [1 ]
Akiyama, Yui [1 ]
Mitsui, Hiroyuki [1 ]
Fujiya, Hiroto [2 ]
机构
[1] St Marianna Univ, Sch Med, Dept Orthopaed Surg, Kawasaki, Kanagawa 2168511, Japan
[2] St Marianna Univ, Sch Med, Dept Sport Med, Kawasaki, Kanagawa 2168511, Japan
关键词
Forefoot deformity; Joint-preserving surgery; Long-term outcome; Metatarsal shortening osteotomy; Rheumatoid arthritis; STANDARD RATING SYSTEM; HALLUX-VALGUS; RADIOGRAPHIC EVALUATION; TELESCOPING OSTEOTOMY; TOE DEFORMITIES; FOOT; RECONSTRUCTION; RELIABILITY; INSTRUMENT; VALIDITY;
D O I
10.3109/14397595.2015.1008672
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objectives. We report the long-term outcome of joint-preserving surgery by combining metatarsal osteotomies for shortening for forefoot deformity in patients with rheumatoid arthritis (RA). Methods. Forty-three patients (57 feet) aged 41.7-70.8 years (mean, 57.7 years) underwent a combination of first tarsometatarsal fusion and distal realignment (modified Lapidus procedure), shortening oblique osteotomies of the bases of metatarsals 2-4, and fifth ray osteotomy (modified Coughlin procedure). Patients were followed up for 64-108 months (mean, 76.6 months). Results. Average postoperative Foot Function Index scores for pain, disability, and activity were 10.3, 19.9, and 16.2, respectively. Average Japanese Society for Surgery of the Foot RA foot and ankle score improved significantly from 52.1 points preoperatively to 90.3 points postoperatively. Postoperatively, 41% of patients reported some forefoot stiffness, but showed no disability. Residual deformity and callosity were absent in all patients. Average hallux valgus and intermetatarsal angles decreased postoperatively from 48.5 degrees to 8.6 degrees and from 15.2 degrees to 4.6 degrees, respectively. Nonunion in two metatarsals, hardware breakage in three, and mild infection in one were identified during follow-up. Conclusions. With good perioperative medical management of RA, surgical repositioning of the metatarsophalangeal joints by proximal metatarsal shortening and consequent relaxing of the surrounding soft tissue shows successful long-term results.
引用
收藏
页码:683 / 688
页数:6
相关论文
共 50 条
  • [31] MID-TERM RESULTS OF ARTHRODESIS OF THE 1ST METATARSOPHALANGEAL JOINT AND RESECTION ARTHROPLASTY OF THE HEADS OF THE LESSER METATARSAL BONES IN COMPARISON WITH JOINT-PRESERVING OPERATIONS ON THE FOREFOOT IN PATIENTS WITH RHEUMATIC DISEASES
    Kapitonov, D.
    Bialik, E.
    Alekseeva, L.
    Makarov, S.
    Makarov, M.
    Bialik, V.
    AGING CLINICAL AND EXPERIMENTAL RESEARCH, 2024, 36 : S219 - S219
  • [32] Long-term results after metatarsal head resection in the treatment of rheumatoid arthritis
    Reize, Patrik
    Leichtle, Carmen Ina
    Leichtle, Ulf Gunther
    Schanbacher, Jrg
    FOOT & ANKLE INTERNATIONAL, 2006, 27 (08) : 586 - 590
  • [33] MEDIUM-TERM AND LONG-TERM RESULTS IN COMPLETE FOREFOOT CORRECTION AFTER TILLMANN IN PATIENTS WITH RHEUMATOID-ARTHRITIS
    HANSENS, C
    HORSTMEYER, M
    TILLMANN, K
    AKTUELLE RHEUMATOLOGIE, 1987, 12 (03) : 222 - 225
  • [34] Long-term mortality outcome in patients with reactive amyloidosis associated with rheumatoid arthritis
    Takeshi Kuroda
    Naohito Tanabe
    Takashi Harada
    Syuichi Murakami
    Hisashi Hasegawa
    Minoru Sakatsume
    Masaaki Nakano
    Fumitake Gejyo
    Clinical Rheumatology, 2006, 25 : 498 - 505
  • [35] Long-term mortality outcome in patients with reactive amyloidosis associated with rheumatoid arthritis
    Kuroda, Takeshi
    Tanabe, Naohito
    Harada, Takashi
    Murakami, Syuichi
    Hisashi, Hasegawa
    Sakatsume, Minoru
    Nakano, Masaaki
    Gejyo, Furnitake
    CLINICAL RHEUMATOLOGY, 2006, 25 (04) : 498 - 505
  • [36] WHAT HAPPENS TO PATIENTS WITH RHEUMATOID-ARTHRITIS - THE LONG-TERM OUTCOME OF TREATMENT
    SPECTOR, TD
    SCOTT, DL
    CLINICAL RHEUMATOLOGY, 1988, 7 (03) : 315 - 330
  • [37] Comparison of the effects of forefoot joint-preserving arthroplasty and resection-replacement arthroplasty on walking plantar pressure distribution and patient-based outcomes in patients with rheumatoid arthritis
    Ebina, Kosuke
    Hirao, Makoto
    Takagi, Keishi
    Ueno, Sachi
    Morimoto, Tokimitsu
    Matsuoka, Hozo
    Kitaguchi, Kazuma
    Iwahashi, Toru
    Hashimoto, Jun
    Yoshikawa, Hideki
    PLOS ONE, 2017, 12 (08):
  • [38] Mid- to long-term biomechanical outcome of joint preserving realignment surgery for ankle osteoarthritis
    Nuesch, Corina
    Barg, Alexej
    Pagenstert, Geert
    Valderrabano, Victor
    SWISS MEDICAL WEEKLY, 2014, 144 : 12S - 12S
  • [39] Recurrence of deformity after silicone implant and resection arthroplasty of the metatarsophalangeal joint for rheumatoid arthritis: long-term results
    Taniguchi, Daigo
    Oda, Ryo
    Ikoma, Kazuya
    Toyama, Shogo
    Takatori, Ryota
    Imai, Kan
    Hara, Yusuke
    Sawada, Koshiro
    Tokunaga, Daisaku
    Fujiwara, Hiroyoshi
    Kubo, Toshikazu
    MODERN RHEUMATOLOGY, 2017, 27 (02) : 266 - 270
  • [40] The long-term results of ankle joint synovectomy for rheumatoid arthritis
    Akagi, S
    Sugano, H
    Ogawa, R
    CLINICAL RHEUMATOLOGY, 1997, 16 (03) : 284 - 290