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

Abstract

The aim was to identify effective surgical treatments for patients with rheumatoid arthritis in the foot and/or ankle. A systematic review of the literature was conducted via a data search of the PubMed, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PROSPERO databases, from their inception until June 2019. Only non-randomized controlled trials and cohort studies were included in this review. Two of the present authors independently assessed the quality of each study and extracted the relevant data. A quality assessment of all articles was performed using the methodological index for non-randomized studies criteria. In addition, the Newcastle Ottawa scale was used for cohort studies. Thirteen studies met the inclusion criteria (five cohort studies and eight NRCTs). The total population considered was 923 patients (570 patients had RA), with a mean age of 58.8 years. Regarding the risk of bias, both the NRCTs and the cohort studies had a moderate level of quality. Despite the relatively low quality of these studies, surgical treatment for the foot and/or ankle is shown to reduce pain and improve functionality in patients with RA, in the short term (6–12 months).

A clinical practice guideline for the management of the foot and ankle in rheumatoid arthritis

“…The surgical technique will depend on the deformity, age and bone quality, as well as the degree of joint destruction [ 49 ]. The surgical techniques most commonly described in the literature are arthroplasty, arthrodesis and osteotomy of the metatarsophalangeal joints (MTP) and total ankle arthroplasty [ 50 ].…”

“…[49]. The surgical techniques most commonly described in the literature are arthroplasty, arthrodesis and osteotomy of the metatarsophalangeal joints (MTP) and total ankle arthroplasty [50].…”