A prospective study of forefoot arthroplasty

Area of Science:

• Orthopedic Surgery
• Rheumatology
• Biomechanics

Background:

• Rheumatoid arthritis frequently causes severe forefoot pain and functional limitations.
• Metatarsal head resection arthroplasty is a surgical option for debilitating forefoot conditions.

Purpose of the Study:

• To evaluate the clinical and objective outcomes of a modified Kates et al. metatarsal head resection arthroplasty.
• To assess the impact of the surgery on pain, mobility, and plantar pressures in rheumatoid arthritis patients.

Main Methods:

• A modified Kates et al. metatarsal head resection arthroplasty was performed on 35 adult rheumatoid arthritis patients.
• Clinical outcomes included patient satisfaction and pain assessment.
• Objective assessment utilized dynamic pedobarography to measure plantar pressures.

Main Results:

• 91% of patients reported satisfaction after a mean 36-month follow-up.
• Significant pain relief was observed, with 42 feet becoming pain-free.
• Pedobarography demonstrated a decrease in abnormal plantar pressures, though some symptomatic feet had normal pressures post-operatively.

Conclusions:

• The modified Kates et al. forefoot arthroplasty is effective in relieving pain and improving mobility for rheumatoid arthritis patients.
• The procedure successfully reduces abnormal plantar pressures.
• This surgical intervention should be considered for patients with rheumatoid arthritis refractory to conservative treatments.