Triple Arthrodesis in Rheumatoid Arthritis

Figgie, Mark P.; O’Malley, Martin J.; Ranawat, Chitranjan S.; Inglis, Allan E.; Sculco, T P

doi:10.1097/00003086-199307000-00033

Cited by 101 publications

(46 citation statements)

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“…In the literature, there are few long-term evaluations of triple arthrodesis with rheumatoid arthritis. Figgie et al followed 40 patients (49 arthrodeses) for an average of 5 years and found bony union in all but two cases and patient satisfaction in 90% [36]. In the present study, three ankle arthrodeses and seven triple arthrodeses were ®xed with bioabsorbable ®xation devices.…”

Section: Discussionmentioning

confidence: 55%

“…Selective arthrodesis has been performed in cases of rheumatoid arthritis radiographically involving only one or two hindfoot joints, triple arthrodesis with involvement of the subtalar, talocalcaneal, and calcaneocuboid joints has been performed, and in cases with ankle joint involvement, pantalar arthrodesis has also been done [22]. Triple arthrodeses have been performed with or without bone autografts (the dowel graft technique, iliac crest grafts) [30,34,35], and external ®xation [22] or metallic screws and staples have been used as ®xation devices [36,37]. Fusion rates with these techniques has been reported at 85±100% in the subtalar joint [34,36,37].…”

Section: Discussionmentioning

confidence: 99%

“…Triple arthrodeses have been performed with or without bone autografts (the dowel graft technique, iliac crest grafts) [30,34,35], and external ®xation [22] or metallic screws and staples have been used as ®xation devices [36,37]. Fusion rates with these techniques has been reported at 85±100% in the subtalar joint [34,36,37]. Nonunion is most commonly seen at the talonavicular area (up to 37% of cases), although in many cases it is painless [35,38].…”

Section: Discussionmentioning

confidence: 99%

“…Nonunion is most commonly seen at the talonavicular area (up to 37% of cases), although in many cases it is painless [35,38]. Progression of ankle joint symptoms after triple arthrodesis has been noticed in 12±21% of patients in former studies; it is still unclear whether this is due to the natural history of the rheumatoid disease or to the changing alignment of the foot after triple fusion [36,39]. Delayed wound healing is not as common as with ankle arthrodesis [22].…”

Section: Discussionmentioning

confidence: 99%

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Long-term results of ankle and triple arthrodeses fixed with self-reinforced polylevolactic acid implants in patients with rheumatoid arthritis

et al. 2001

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Self-reinforcing polylevolactic acid (SR-PLLA) implants have been used in arthrodeses of patients with rheumatoid arthritis. No long-term evaluation has been published so far. Two patients (three ankles) with destruction of the ankle joint and seven with destruction of the subtalar joint received ten arthrodeses. One out of three ankle arthrodeses healed and nonunion developed in two. Five out of seven triple arthrodeses attained bony union. Two patients with malunion of the subtalar and talonavicular joints are free of symptoms and need no reoperation. One superficial wound infection healed by oral antibiotics. In one patient, an ankle arthrodesis was performed 6 years after the triple arthrodesis of the left foot. SR-PLLA implants can be used in triple arthrodesis in rheumatoid arthritic patients with good results comparable to those of other studies. The problems with nonunion of ankle arthrodeses noticed in former studies are also attributable to this fixation method.

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Section: Discussionmentioning

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Long-term results of ankle and triple arthrodeses fixed with self-reinforced polylevolactic acid implants in patients with rheumatoid arthritis

et al. 2001

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“…The fixation method per se (staple, screw, or pin) is of less importance. Progression of ankle joint pain does occur, and seems to be correlated to persistent val- gus malalignment of the hindfoot and midfoot [13].…”

Section: Arthrodesis Of the Hind-and Midfootmentioning

confidence: 99%

The foot

2000

Acta Orthopaedica Scandinavica

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Radiologic Patterning of Joint Damage to the Foot in Rheumatoid Arthritis

Matsumoto

Nakamura

Miura

et al. 2014

Arthritis Care & Research

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Objective. Foot and ankle deformities greatly affect the quality of life of rheumatoid arthritis (RA) patients. The aim of this study was to elucidate the pattern of destruction of the RA foot and its impact on patients. Methods. We cross-sectionally investigated RA patients (274 patients and 542 feet) using radiographs. The grade of joint destruction was assigned using Larsen's grading system for 12 joints in the foot and ankle. Cluster analysis was performed using the K-means method to classify the pattern of joint destruction. Of the 274 patients evaluated radiographically, 212 were assessed for functional disability using questionnaires. Results. Cluster analysis revealed that 542 feet were divided into 5 clusters, named according to the characteristic distribution of joint destruction: cluster I (normal type), cluster II (forefoot type), cluster III (midfoot type), cluster IV (mid-hindfoot type), and cluster V (combined type). Radiographic measurements revealed the characteristic deformities of each cluster: splay foot for cluster II, flat foot for cluster III, hindfoot malalignment for cluster IV, and mixtures of these characteristics for cluster V. A distribution map of each cluster based on disease duration revealed that cluster III peaked in cases of 5-10-year disease duration and subsequently decreased, followed by a gradual increase of cluster IV and cluster V. Cluster IV and cluster V showed significant changes in functional disability compared to cluster III. Conclusion. This report is the first to reveal the pattern of RA foot deformities and their impact on patients using statistical measures in a large series.

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Triple Arthrodesis in Rheumatoid Arthritis

Cited by 101 publications

References 0 publications

Long-term results of ankle and triple arthrodeses fixed with self-reinforced polylevolactic acid implants in patients with rheumatoid arthritis

Long-term results of ankle and triple arthrodeses fixed with self-reinforced polylevolactic acid implants in patients with rheumatoid arthritis

The foot

Radiologic Patterning of Joint Damage to the Foot in Rheumatoid Arthritis

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