Involvement of valgus hindfoot deformity in hallux valgus deformity in rheumatoid arthritis

Yamada, Shutaro; Hirao, Makoto; Tsuboi, Hideki; Akita, Shosuke; Matsushita, M.; Ohshima, Shiro; Saeki, Yukihiko; Hashimoto, Jun

doi:10.1007/s10165-013-0835-x

Cited by 5 publications

(6 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In such cases, additional assessment may be needed about the overall deformity, including cases of hindfoot deformity. [28][29][30] High preoperative HVA was also identified as a risk factor for varus deformity. In addition, overcorrection of HVA was considered a possible cause.…”

Section: Discussionmentioning

confidence: 97%

See 1 more Smart Citation

Preoperative degree of deformity and underlying disease affect the postoperative deformity of joint-preserving hallux valgus surgery

Takami,

Tsuji,

Owaki

2023

J Orthop Surg (Hong Kong)

View full text Add to dashboard Cite

Background The combination of distal osteotomy with lateral dissection in joint-preserving surgery for severe hallux valgus deformity has recently begun to yield encouraging results. We examined the frequency of complications and risk factors of those for joint-preserving surgery in patients with and without rheumatoid arthritis (RA). Methods A retrospective, observational study of 72 feet (27 patients with RA) was performed. The inclusion criteria were patients who underwent joint-preserving surgery for hallux valgus deformity at our hospital between January 2008 and March 2016 who could be followed up with for longer than 12 months. Results The mean preoperative and immediate postoperative hallux valgus angles (HVA) were 41.8 and 4.4, respectively. The mean preoperative and immediate postoperative intermetatarsal angles between the first and second metatarsal bones (M1-M2A) were 14.6 and 5.8, respectively. At the final postoperative evaluation, the mean HVA was 8.8 and the mean M1-M2A was 6.4. Data were compared among the patients with complications (recurrent valgus deformity, varus deformity), and those without complications (normal HVA) at the final postoperative evaluation. The rate of RA in the varus deformity group was 71.4%, which tended to be higher than in other groups ( p = .058). The mean preoperative HVA were 48.2 and 52.6 in the group of recurrent valgus deformity and varus deformity, which was higher than the normal HVA group ( p = .001). Conclusions High preoperative HVA was a risk factor for the recurrence of valgus deformity. Most of the varus deformities were observed in the RA group with high preoperative HVA; therefore, caution should be exercised in operating on patients with severe deformity or those with RA. Level of evidence III.

show abstract

Section: Discussionmentioning

confidence: 97%

“…In such cases, additional assessment may be needed about the overall deformity, including cases of hindfoot deformity. 28–30…”

Section: Discussionmentioning

confidence: 99%

Preoperative degree of deformity and underlying disease affect the postoperative deformity of joint-preserving hallux valgus surgery

Takami,

Tsuji,

Owaki

2023

J Orthop Surg (Hong Kong)

View full text Add to dashboard Cite

show abstract

“…From these observations, it is plausible that recurrence of joint subluxation in the MTP of the lesser toe was considered to occur easily in feet with increased M2-M5A [2] and/or varus hindfoot [3]. On the other hand, the associations of valgus hindfoot with HV [12], valgus hindfoot change inducing recurrence of HV [13,14], or correction of valgus hindfoot restoring HV deformity were also considered proper [15]. At present, however, information remains lacking on the clinical features of these intermetatarsal angles.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of Intermetatarsal Angle Between the Second and Fifth Metatarsals (M2-M5A) in the Rheumatoid Foot

Noguchi¹,

Hirao²,

Tsuji³

et al. 2022

Cureus

Self Cite

View full text Add to dashboard Cite

Background: Increasing of intermetatarsal angle between the first and second metatarsals (M1-M2A) has been reported as a risk factor for recurrence of hallux valgus (HV) deformity, on the other hand, increasing of intermetatarsal angle between the second and fifth metatarsals (M2-M5A) has been reported as a risk factor for resubluxation of the metatarsophalangeal (MTP) joint of the lesser toe after rheumatoid forefoot surgery. In this study, parameters related to increasing M2-M5A were investigated, as compared with M1-M2A and M1-M5A.Methods: Radiographic parameters including M1-M2A, M1-M5A, and M2-M5A were retrospectively evaluated for 119 lower limbs from 68 patients with rheumatoid arthritis (RA). To clarify the clinical importance of these intermetatarsal angles, relationships with results from the timed up-and-go (TUG) test were also investigated.Results: M1-M5A showed no correlation with mid-hind foot parameters, whereas M1-M2A and M2-M5A correlated with valgus/varus parameters. An increased M1-M2A was associated with lateral shift of the loading axis in the tibial plafond, whereas an increased M2-M5A was associated with medial shift, but M1-M5A showed no associations. M2-M5A/M1-M2A was significantly lower (1.7) in the normal TUG group than in the delayed TUG group (2.8) (p=0.045).Conclusions: Different patterns of spread are seen for the forefoot. One has a predominantly increased M1-M2A with lateral shift of the loading point in the tibial plafond, whereas the other has a predominantly increased M2-M5A with medial shift of the loading point in the tibial plafond. M2-M5A also should be calculated, and M2-M5A/M1-M2A might be meaningful in understanding physical mobility in RA patients.Categories: Orthopedics, Rheumatology, Podiatry Keywords: timed up-and-go (tug) tests, loading axis, intermetatarsal angle between 1st and 2nd metatarsals (m1-m2a), rheumatoid arthritis (ra), intermetatarsal angle between 2nd and 5th metatarsals (m2-m5a)

show abstract

“…Based on Pearson product-moment correlation coefficient test, involvement of HV deformity must be always considered when assessing forefoot deformities and disorders in RA patients whether or not there will be dorsal dislocation of second MTP joint. Indeed, we experienced a case in which HV deformity was instantly normalized by correction of severe valgus hindfoot, calcaneal lateral offset, and pronated foot deformity without any forefoot treatment [19]. Thus, careful hindfoot status evaluation is important when assessing forefoot deformity.…”

Section: Discussionmentioning

confidence: 99%

“…The calcaneal lateral offset was defined as the distance (mm) between the axis of the tibia and calcaneus [19], as shown in figure 2.…”

Section: Hindfootmentioning

confidence: 99%

Hind-mid-forefoot Deformity in Hallux Valgus Deformity in Rheumatoid Arthritis: Radiographic Evaluation Grouped by Existence of Dorsal Dislocation of Second Metatarsophalangeal Joint

Tsuboi¹

2013

Rheumatol Curr Res

View full text Add to dashboard Cite

Hallux valgus deformity combined with dorsal dislocation of the second metatarsophalangeal joint is frequently observed in rheumatoid arthritis cases. However, hallux valgus deformity without lesser toe dislocation is also seen in rheumatoid cases. Dislocated second toe cause the loss of the lateral support on the hallux, suggesting the importance to confirm the state of lesser toe MTP joint when assessing the risk of HV recurrence after surgery, and there may be some differences in the mechanical transmission between hind-mid and forefoot based on whether dorsal dislocation of the MTP joint in the lesser toe is present, although findings are unclear. This study examined the relationship between radiographic findings from the hind, mid, and forefoot and hallux valgus angle in rheumatoid arthritis cases grouped based on the presence or absence of dorsal dislocation of the second metatarsophalangeal joint. X-rays of 160 feet and ankles with rheumatoid arthritis were evaluated for the first metatarsophalangeal Larsen grade, existence of second metatarsophalangeal dorsal dislocation, hallux valgus angle, intermetatarsal angle between the first and second intermetatarsals, shape of the first metatarsal head, position of the sesamoid, the metatarsus primus varus angle, diastasis between the base of the first and second metatarsals, angle between long axis of the talus and short axis of the navicular, internal arch angle, tibio-calcaneal angle, and calcaneal lateral offset. Based on Pearson product-moment correlation coefficient test, involvement of hindfoot deformity should always be considered when assessing hallux valgus deformity in rheumatoid arthritis patients. Although mechanism of mechanical transmission through hindfoot to Lisfranc joint seems to be different by the presence or absence of dorsal dislocation of the second metatarsophalangeal joint, Lisfranc looseness also must be considered when assessing hallux valgus including the surgery to avoid the progression or recurrence in rheumatoid arthritis cases. Dorsal dislocation of the second metatarsophalangeal joint strongly influences the exacerbation of hallux valgus in rheumatoid arthritis cases. Thus, it is may be important to achieve adequate reduction of the second metatarsophalangeal joint dislocation and make a stable metatarsophalangeal joint to avoid recurrence of hallux valgus after forefoot surgery in rheumatoid arthritis.

show abstract

Involvement of valgus hindfoot deformity in hallux valgus deformity in rheumatoid arthritis

Cited by 5 publications

References 6 publications

Preoperative degree of deformity and underlying disease affect the postoperative deformity of joint-preserving hallux valgus surgery

Preoperative degree of deformity and underlying disease affect the postoperative deformity of joint-preserving hallux valgus surgery

Characteristics of Intermetatarsal Angle Between the Second and Fifth Metatarsals (M2-M5A) in the Rheumatoid Foot

Hind-mid-forefoot Deformity in Hallux Valgus Deformity in Rheumatoid Arthritis: Radiographic Evaluation Grouped by Existence of Dorsal Dislocation of Second Metatarsophalangeal Joint

Contact Info

Product

Resources

About