Joint-Preserving Surgery for Forefoot Deformities in Patients with Rheumatoid Arthritis: A Literature Review

Yano, Koichiro; Ikari, Katsunori; Tobimatsu, Haruki; Tominaga, Ayako; Okazaki, Ken

doi:10.3390/ijerph18084093

Cited by 12 publications

(10 citation statements)

References 54 publications

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“…Other procedures include first metatarsophalangeal fusion, in isolation or combined with the aforementioned arthroplasty [3]. Other techniques include joint-preserving surgery, consisting of metatarsal osteotomy and soft tissue reconstruction, with metatarsophalangeal joint function preservation [3,13]. Debridement of plantar callosities may offer some pain relief [3].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic and Therapeutic Challenge of Metatarsalgia in a Patient With Rheumatoid Arthritis

Malta¹,

Martins²,

Azenha³

et al. 2022

Cureus

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A 63-year-old female patient, with a past history of rheumatoid arthritis, presented with insidious pain on the left foot second and third metatarsophalangeal joints, associated with swelling and morning stiffness (mean time: four hours). Physical examination evidenced a tender and soft nodularity in the third intermetatarsal space, along with sharp pain, consistent with Morton's neuroma. Foot ultrasound suggested Morton's neuroma, but not excluding the possibility of rheumatoid arthritis involvement. Foot magnetic resonance imaging suggested the possibility of extensive synovitis of the third metatarsophalangeal joint, but not excluding the coexistence of Morton's neuroma because of the mass effect. Finally, the patient underwent an ultrasound-guided needle biopsy of the nodule, which confirmed metatarsophalangeal joint synovitis. The foot is a common location of rheumatoid arthritis manifestation, and metatarsophalangeal joint synovitis can mimic Morton's neuroma. After a definite diagnosis, the patient recovered lower limb functional impairment after introducing adalimumab and a rehabilitation program. This case highlights the importance of an accurate differential diagnosis, pharmacological rheumatoid arthritis control, and physical medicine and rehabilitation programs to optimal clinical and functional improvement.

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Section: Discussionmentioning

confidence: 99%

Diagnostic and Therapeutic Challenge of Metatarsalgia in a Patient With Rheumatoid Arthritis

Malta¹,

Martins²,

Azenha³

et al. 2022

Cureus

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“…In this study, the PROM scores in all subscales regarding pain, physical function, social functioning, shoe-related, and general health improved significantly after the procedure for correcting HV. Joint-preserving arthroplasty for correcting rheumatoid forefoot deformities is becoming increasingly popular as it results in better function and satisfaction in patients than resection arthroplasty [8]; however, only a few studies have evaluated the effectiveness of joint-preserving arthroplasty for correcting rheumatoid forefoot deformities using PROM scores. In a retrospective study of 35 feet, Ebina et al reported that joint-preserving arthroplasty, including modified scarf osteotomy for the hallux and off-set shortening osteotomy for the lesser toes, significantly improved all SAFE-Q subscale scores [24].…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, resection arthroplasty is not considered suitable for patients who need to perform high-level activities of daily living. Owing to recent advances in pharmacological treatment, there has been a trend toward joint-preserving arthroplasty instead of resection arthroplasty for maintaining joint function [8]. Using plantar pressure measurement, a few studies have demonstrated that joint-preserving arthroplasty for rheumatoid forefoot could improve push-off by the forefoot during gait [7,9].…”

Section: Introductionmentioning

confidence: 99%

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

Matsumoto

Maenohara

Chang

et al. 2021

IJERPH

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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.

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“…Generell zeigte sich ein zufriedenstellendes Ergebnis in den kurz- bis mittelfristigen Verläufen in der radiologischen Auswertung, Langzeitergebnisse hingegen sind bislang leider nur unzureichend vorhanden 12 .…”

Section: Tmt I Arthrodese Versus Proximale Oder Distale Osteotomienunclassified

Unterschiede in der Therapie entzündlich rheumatischer und degenerativer Füße. Die Vorfußchirurgie

Hassel

2022

Aktuelle Rheumatologie

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ZusammenfassungDer Unterschied zwischen rheumatischen und degenerativen Veränderungen am Fuß liegt in der fortschreitenden Destruktion der Gelenke bei persistierender Synovialitis der rheumatoiden Arthritis (RA). Unter der heute wirksameren immunsuppressiven Therapie und eines frühen und aggressiven Beginns zeigen sich mildere Verlaufsformen. So können zunehmend auch gelenkerhaltende Verfahren der Vorfußchirurgie Anwendung finden. Entscheidend ist hier jedoch die Remission mit sicherer Krankheitskontrolle für den gelenkerhaltenden Eingriff. Dennoch ist das Rezidiv- und Fehlstellungsrisiko aufgrund wiederkehrender arthritischer Phasen höher. Rheumaorthopädische Standardverfahren, wie die Arthrodese des Großzehengrundgelenkes mit Resektion der Metatarsaleköpfchen haben aber Ihren Stellenwert beim Vollbild des erosiven rheumatischen Vorfußes nicht verloren. Ein standardisiertes Vorgehen fehlt. Umso wichtiger ist es, mit jedem Patienten individuell die richtigen Maßnahmen zu festzulegen.

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Joint-Preserving Surgery for Forefoot Deformities in Patients with Rheumatoid Arthritis: A Literature Review

Cited by 12 publications

References 54 publications

Diagnostic and Therapeutic Challenge of Metatarsalgia in a Patient With Rheumatoid Arthritis

Diagnostic and Therapeutic Challenge of Metatarsalgia in a Patient With Rheumatoid Arthritis

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

Unterschiede in der Therapie entzündlich rheumatischer und degenerativer Füße. Die Vorfußchirurgie

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