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Triple arthrodesis in rheumatoid arthritis
M P Figgie1, M J O'Malley, C Ranawat
1Hospital for Special Surgery, New York, NY 10021.
Clinical Orthopaedics and Related Research
|July 1, 1993
Summary
Triple arthrodesis surgery significantly relieves pain and improves walking ability for rheumatoid arthritis patients. This procedure offers a high success rate for those suffering from severe hindfoot deformities.
Area of Science:
- Orthopedic Surgery
- Rheumatology
Background:
- Rheumatoid arthritis frequently causes severe hindfoot deformities, leading to significant pain and impaired mobility.
- Surgical intervention is often necessary to address these debilitating symptoms.
Purpose of the Study:
- To evaluate the long-term clinical and radiographic outcomes of triple arthrodesis in patients with rheumatoid arthritis.
- To assess the efficacy of triple arthrodesis in pain reduction and improvement of ambulatory function.
Main Methods:
- A retrospective review of 49 triple arthrodesis procedures in 40 rheumatoid arthritis patients (1975-1985).
- Standard surgical technique included medial and lateral incisions, staple fixation, local bone grafting, and closing wedge osteotomies for deformity correction.
- Clinical and radiographic evaluations were performed with an average follow-up of five years.
Main Results:
- Postoperatively, 94% of patients reported significant pain relief, with 83% experiencing complete pain relief.
- Ambulatory status improved in 80% of patients, with 90% achieving community ambulation.
- Complications were minimal, including superficial wound infections and one case of pseudarthrosis requiring revision. No significant progression of other foot or knee symptoms was noted.
Conclusions:
- Triple arthrodesis is a highly effective procedure for rheumatoid arthritis patients with hindfoot deformities, demonstrating a high union rate.
- The surgery provides substantial pain relief and significantly improves functional ambulation, making it a valuable treatment option.