First Ray Resection Arthroplasty versus Arthrodesis in the Treatment of the Rheumatoid Foot

Abstract

Patients with arthrodesis revealed better foot function during the dynamic roll-over process even though the resection arthroplasty patients were subjectively more satisfied.

Radiologic Patterning of Hallux Deformity in Rheumatoid Arthritis and Its Relationship to Flatfoot

“…Arthrodesis and resection have been the 2 major options for the first MTP joint in reconstructive surgery of the rheumatoid forefoot (28). In contrast, the advancement in RA disease control, as typified by the development of biologic agents, has prompted surgeons to reconsider the benefits of joint preservation, and several attempts to preserve the MTP joint have recently been reported (29)(30)(31)(32).…”

Surgical Treatment for the Ankle and Foot in Patients with Rheumatoid Arthritis: A Systematic Review

“…Our findings are based on NRCTs and cohort studies, which show that surgical treatment for these patients usually decreases pain and enhances functionality, assessed over a follow-up period of at least 12 and six months, respectively [19,25]. All of these studies used an objective measuring instrument, providing validity, reliability, and responsiveness, underpinning the measurements obtained for the clinical variables observed in the patients after the surgical technique in question had been performed [25].…”

“…For patients with RA studies, the most common surgical procedures investigated are arthrodesis of the first MTP joint and/or arthroplasties of the MTP joints [19,20,38,43], since these patients are particularly subject to deformities in the forefoot (such as hallux valgus, hallux rigidus, floating of the lesser toes or synovial inflammation of the MTP joints) or in the hindfoot (such as hindfoot valgus or flat foot), which can aggravate pain and disability among this population [10,17]. This combination of techniques was most commonly used in the studies considered and achieved the best results, both in relieving pain and in enhancing functionality (p < 0.001) [19,20,40,43]. However, there is no evidence that this is more effective than arthroplasty in all the metatarsal heads (or the fist metatarsal), because according to the papers included in our analysis, the only related research conducted were case studies [18,45,46], which are considered to present low methodological quality.…”

“…Surgical techniques are most commonly applied to the forefoot [17], but the hindfoot and ankle are also treated [18]. The surgical procedures for the forefoot are arthrodesis of the first MTP joint and/or arthroplasties of the MTP joints [19,20] and surgical treatments to the ankle are total arthroplasty and prosthesis [21,22]. Studies have been conducted to describe and examine the role played by different surgical techniques for the foot and ankle for patients with RA [23][24][25] but to date no systematic review has been undertaken to assess their impact on pain relief and improved functionality.…”

Towards a better understanding of foot and ankle kinematics in rheumatoid arthritis : the effects of walking speed and structural impairments

“…Improvements in imaging technologies such as magnetic resonance imaging and ultrasound enable such detailed clinical observations of pathological changes. Concurrently, initiatives have started to classify foot pathologies and investigate the possibilities and effects of conservative and surgical foot and ankle interventions [Doorn 2011, Hennessy 2011, Rosenbaum 2011, Van der Heijde 2010, Van der Leeden 2011, Walmsley 2010, Woodburn 2003]. …”