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Lee H, Ishikawa H, Shibuya T, Takai C, Nemoto T, Nomura Y, Abe A, Otani H, Ito S, Nakazono K, Abe K, Nakanishi K, Murasawa A. The Combination of Modified Mitchell's Osteotomy and Shortening Oblique Osteotomy for Patients with Rheumatoid Arthritis: An Analysis of Changes in Plantar Pressure Distribution. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18199948. [PMID: 34639247 PMCID: PMC8508268 DOI: 10.3390/ijerph18199948] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 09/17/2021] [Accepted: 09/18/2021] [Indexed: 11/16/2022]
Abstract
The present study aims to evaluate changes in plantar pressure distribution after joint-preserving surgery for rheumatoid forefoot deformity. A retrospective study was performed on 26 feet of 23 patients with rheumatoid arthritis (RA) who underwent the following surgical combination: modified Mitchell's osteotomy (mMO) of the first metatarsal and shortening oblique osteotomy of the lateral four metatarsals. Plantar pressure distribution and clinical background parameters were evaluated preoperatively and one year postoperatively. A comparison of preoperative and postoperative values indicated a significant improvement in the visual analog scale, Japanese Society for Surgery of the Foot scale, and radiographic parameters, such as the hallux valgus angle. A significant increase in peak pressure was observed at the first metatarsophalangeal joint (MTPJ) (0.045 vs. 0.082 kg/cm2; p < 0.05) and a significant decrease at the second and third MTPJs (0.081 vs. 0.048 kg/cm2; p < 0.05, 0.097 vs. 0.054 kg/cm2; p < 0.05). While overloading at the lateral metatarsal heads following mMO has been reported in previous studies, no increase in peak pressure at the lateral MTPJs was observed in our study. The results of our study show that this surgical combination can be an effective and beneficial surgical combination for RA patients with mild to moderate joint deformity.
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Affiliation(s)
- Hyunho Lee
- Department of Rheumatology, Niigata Rheumatic Center, Niigata 957-0054, Japan; (H.I.); (T.S.); (C.T.); (T.N.); (Y.N.); (A.A.); (H.O.); (S.I.); (K.N.); (A.M.)
- Department of Orthopaedic Surgery, Nihon University School of Medicine, Tokyo 173-8610, Japan;
- Correspondence: ; Tel.: +81-3-3972-8111
| | - Hajime Ishikawa
- Department of Rheumatology, Niigata Rheumatic Center, Niigata 957-0054, Japan; (H.I.); (T.S.); (C.T.); (T.N.); (Y.N.); (A.A.); (H.O.); (S.I.); (K.N.); (A.M.)
| | - Tatsuaki Shibuya
- Department of Rheumatology, Niigata Rheumatic Center, Niigata 957-0054, Japan; (H.I.); (T.S.); (C.T.); (T.N.); (Y.N.); (A.A.); (H.O.); (S.I.); (K.N.); (A.M.)
| | - Chinatsu Takai
- Department of Rheumatology, Niigata Rheumatic Center, Niigata 957-0054, Japan; (H.I.); (T.S.); (C.T.); (T.N.); (Y.N.); (A.A.); (H.O.); (S.I.); (K.N.); (A.M.)
| | - Tetsuya Nemoto
- Department of Rheumatology, Niigata Rheumatic Center, Niigata 957-0054, Japan; (H.I.); (T.S.); (C.T.); (T.N.); (Y.N.); (A.A.); (H.O.); (S.I.); (K.N.); (A.M.)
| | - Yumi Nomura
- Department of Rheumatology, Niigata Rheumatic Center, Niigata 957-0054, Japan; (H.I.); (T.S.); (C.T.); (T.N.); (Y.N.); (A.A.); (H.O.); (S.I.); (K.N.); (A.M.)
| | - Asami Abe
- Department of Rheumatology, Niigata Rheumatic Center, Niigata 957-0054, Japan; (H.I.); (T.S.); (C.T.); (T.N.); (Y.N.); (A.A.); (H.O.); (S.I.); (K.N.); (A.M.)
| | - Hiroshi Otani
- Department of Rheumatology, Niigata Rheumatic Center, Niigata 957-0054, Japan; (H.I.); (T.S.); (C.T.); (T.N.); (Y.N.); (A.A.); (H.O.); (S.I.); (K.N.); (A.M.)
| | - Satoshi Ito
- Department of Rheumatology, Niigata Rheumatic Center, Niigata 957-0054, Japan; (H.I.); (T.S.); (C.T.); (T.N.); (Y.N.); (A.A.); (H.O.); (S.I.); (K.N.); (A.M.)
| | - Kiyoshi Nakazono
- Department of Rheumatology, Niigata Rheumatic Center, Niigata 957-0054, Japan; (H.I.); (T.S.); (C.T.); (T.N.); (Y.N.); (A.A.); (H.O.); (S.I.); (K.N.); (A.M.)
| | - Kaoru Abe
- Department of Prosthetics, Orthotics and Assistive Technologies, Niigata University of Health and Welfare, Niigata 950-3198, Japan;
| | - Kazuyoshi Nakanishi
- Department of Orthopaedic Surgery, Nihon University School of Medicine, Tokyo 173-8610, Japan;
| | - Akira Murasawa
- Department of Rheumatology, Niigata Rheumatic Center, Niigata 957-0054, Japan; (H.I.); (T.S.); (C.T.); (T.N.); (Y.N.); (A.A.); (H.O.); (S.I.); (K.N.); (A.M.)
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Joint-Preserving Surgery for Forefoot Deformities in Patients with Rheumatoid Arthritis: A Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084093. [PMID: 33924481 PMCID: PMC8068870 DOI: 10.3390/ijerph18084093] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/23/2021] [Accepted: 04/08/2021] [Indexed: 11/17/2022]
Abstract
The combination of first metatarsophalangeal joint arthrodesis and resection arthroplasty of all lesser metatarsal heads has been historically considered the golden standard treatment for rheumatoid forefoot deformities. However, as recent improved management of rheumatoid arthritis have reduced progression of joint destruction, the surgical treatments for rheumatoid forefoot deformities have gradually changed from joint-sacrificing surgery, such as arthrodesis and resection arthroplasty, to joint-preserving surgery. The aim of this literature review was to provide current evidence for joint-preserving surgery for rheumatoid forefoot deformities. We focused on the indications, specific outcomes, and postsurgical complications of joint-preserving surgery in this review.
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Yano K, Saito H, Ikari K, Okazaki K. Impact of joint-preserving surgery on plantar pressure among patients with rheumatoid arthritis. Mod Rheumatol 2019; 30:604-606. [DOI: 10.1080/14397595.2019.1627741] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Koichiro Yano
- Department of Orthopedic Surgery, Tokyo Women’s Medical University, Tokyo, Japan
| | - Hiroharu Saito
- Department of Orthopedic Surgery, Tokyo Women’s Medical University, Tokyo, Japan
| | - Katsunori Ikari
- Department of Orthopedic Surgery, Tokyo Women’s Medical University, Tokyo, Japan
| | - Ken Okazaki
- Department of Orthopedic Surgery, Tokyo Women’s Medical University, Tokyo, Japan
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