Clinical and functional evaluation of forefoot reconstruction in patients with rheumatoid arthritis

Abstract

Objectiveto evaluate the long-term results from reconstruction of the forefoot in patients with rheumatoid arthritis who underwent arthrodesis of the metatarsophalangeal joint of the hallux, resection arthroplasty of the heads of the lateral metatarsals and correction of the deformities of the smaller toes through arthrodesis of the proximal interphalangeal joint or closed manipulation.Methodsseventeen patients (27 feet) who underwent forefoot reconstruction surgery by means of arthrodesis of the first metatarsophalangeal joint, resection of the heads of the lateral metatarsals and correction of the deformities of the smaller toes, were studied retrospectively. The mean follow-up was 68 months (12–148 months); the mean age was 52 years (range: 20–75 months); and four patients were male and 13 were female.Resultsthe results were classified as excellent in 17 feet, good in two, fair in four and poor in two. The mean score on the AOFAS scale was 70 points; 21 feet (78%) were found to be asymptomatic; and six feet (22%) presented some type of symptom. Three feet presented pseudarthrosis, and one of these successfully underwent revision of the arthrodesis. There was no significant difference in scoring on the AOFAS scale or in the consolidation rate, between using a plate and screws and using Kirschner wires for fixation of the arthrodesis.Conclusionarthrodesis of the first metatarsophalangeal joint with resection arthroplasty on the heads of the lateral metatarsals and correction of the deformities of the smaller toes, which was used in forefoot reconstruction in rheumatoid patients, showed good long-term results with a high satisfaction rate among the patients and clinical-functional improvement.

A randomized study comparing the effect of platelet-rich plasma and platelet-poor plasma for the treatment of plantar fasciitis

“…Despite this positive effect on VAS scores, this improvement was not reflected in the quality-of-life pattern of the patients, contradicting partially the results described by Freire et al (2020) in which the application of plasma reduced pain and improved quality of life. Other studies (Costa, Backer & Ferreira, 2014, Andia, Sanchez & Maffulli, 2010 have also observed the progressive improvement of patients' quality of life via the AOFAS score over different evaluation times.…”