Implant Arthroplasty of the Great Toe with Resection Arthroplasty of the Other Toes for Rheumatoid Arthritis Forefoot Deformity
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概要
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Purpose: We replaced the first metatarsophalangeal (MTP) joint with a Swanson hinge toe implant and conducted resection arthroplasty of the other toes for forefoot deformity in rheumatoid arthritis (RA) . We assessed the effect of the first metatarsal bone excision volume.<BR>Patients and Methods: Subjects were 19 RA women who underwent implant arthroplasty of the great toe with resection arthroplasty of the other toes for forefoot deformities. They were divided into two groups by first metatarsal bone excision volume. Group A consisted of 11 patients and 18 feet with the bone removed only the width that an implant could be entered. Group B consisted of 8 patients and 11 feet with the bone removed the same volume as for the other toes. Radiological assessment and complications were studied retrospectively and statistically analyzed between groups.<BR>Results: The mean hallux valgus angle (HVA) in group A, decreased significantly from 44.8° to 28.8° and in group B from 43.5° preoperatively to 15.1° postoperatively, and to 32.7° in group A and 16.0° in group B at the last follow-up (p<0.01) . Significant differences were seen between groups postoperatively and in follow-up (p<0.01) . The angle between the first and the second metatarsal bones and that between the first and fifth were not significant. Conclusion: Our results suggest that increased bone excision of the first metatarsal bone in implant arthroplasty of the great toe may correct and maintain HVA of RA forefoot deformity.
- 日本関節病学会の論文
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