Appearance of hindfoot valgus deformity and recurrence of hallux valgus in the very early period after hallux valgus surgery in a poorly controlled rheumatoid arthritis case: A case report

Hirao, Makoto; Ebina, Kosuke; Tsuboi, Hideki; Noguchi, Takaaki; Hashimoto, Jun; Yoshikawa, Hideki

doi:10.1080/14397595.2016.1209817

Cited by 10 publications

(6 citation statements)

References 10 publications

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“…In the present study, the recurrence rate of HV deformities was 13.9%, which was not worse compared with that reported in previous studies on joint-preserving surgery in patients with RA (0-40%) [11,[13][14][15][16]37,38]. Reported risk factors for recurrent HV after joint-preserving procedures in patients with RA include severe preoperative deformity, high preoperative RA disease activity, splayfoot, and hindfoot malalignment [13,15,39,40]. Patients with recurrent HV had a higher preoperative HVA compared with those without recurrent HV, suggesting an association between severe preoperative deformity and recurrent HV.…”

Section: Discussionsupporting

confidence: 49%

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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Section: Discussionsupporting

confidence: 49%

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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“…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: 98%

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)

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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.

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“…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

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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)

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Appearance of hindfoot valgus deformity and recurrence of hallux valgus in the very early period after hallux valgus surgery in a poorly controlled rheumatoid arthritis case: A case report

Cited by 10 publications

References 10 publications

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

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

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

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