Proximal rotational closing-wedge osteotomy of the first metatarsal in rheumatoid arthritis: clinical and radiographic evaluation of a continuous series of 35 cases

Abstract

Rotational closing-wedge osteotomy of the first metatarsal was beneficial for correcting forefoot deformities in RA over the short term.

Outcomes of Resection and Joint-Preserving Arthroplasty for Forefoot Deformities for Rheumatoid Arthritis

“…On the other hand, various modifications of joint-preserving procedures have also been performed with good clinical results. 3,11,13,14,33,34,36,42 Joint-preserving procedures for the correction of RA-associated forefoot deformities has some advantages. It contributes to reconstruction of the transverse metatarsal arch, corrects the deformity, and preserves the joint function (especially the fulcrum of the flexor tendon).…”

“…However, the joint-preserving procedure also has some disadvantages: potential recurrence of hallux valgus deformity, 36 forefoot stiffness, 22,33 or severe destruction of the metatarsal head is not a good indication for a joint-preserving procedure. 9,33,42 The SOO method described by Hanyu et al 11 involved temporary fixation of the osteotomy sites by 1.2-mm K-wires from the distal phalanx to the metatarsal shaft. The K-wires are removed 3 weeks postoperatively.…”

“…Several joint-preserving procedures have been reported to yield good clinical results. 11,13,14,33,34,36,42 We recently reported on correctional osteotomies of the first metatarsal and shortening oblique osteotomy (SOO) of the lesser metatarsals to preserve joint function as an alternative to joint-sacrificing surgeries. 34 In the current study, we investigated the clinical and radiographic outcomes of resection and joint-preserving arthroplasty for forefoot deformities in patients with RA.…”

Recent Trends in Orthopedic Surgery Aiming to Improve Quality of Life for Those with Rheumatoid Arthritis: Data from a Large Observational Cohort

“…Similarly, the number of prosthetic joint replacements has gradually decreased since 2003, but began to stabilize around 2008 (Figure 2). The arthroplasties included wrist arthroplasty, such as the Sauvé-Kapandji procedure; procedures for correcting boutonniere deformity and swan-neck deformity; and foot arthroplasties (i.e., correction of forefoot deformity using metatarsal head resection or metatarsophalangeal joint-preserving surgery) 6 . However, the rates of prosthetic joint replacement surgeries have changed dramatically over time ( Figure 3A).…”

Effect of an orthosis on foot center of pressure translation for treatment of hallux valgus in patients with rheumatoid arthritis: A report of 17 cases

“…The 1st MTP joint deformity often causes lessor toe deformities and midfoot instability 8 . In patients with RA, the surgeries for HV, such as arthrodesis, resection arthroplasty, and osteotomy, have been reported to show good clinical results 9, 10, 11, 12. Conversely, in nonsurgical treatment for HV, education, footwear, orthoses, and anti-inflammatory drugs have been recommended and their efficacies have been reported 13, 14, 15.…”