Surgical treatment of rheumatoid forefoot

evaluation of functional outcome and quality of life

  • Rodrigo Sousa Macedo Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil https://orcid.org/0000-0002-5025-4338
  • Eduardo Araujo Pires Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil https://orcid.org/0000-0001-6008-8671
  • Rafael Barban Sposeto Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil https://orcid.org/0000-0003-1085-0917
  • Marcos Hideyo Sakaki Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil https://orcid.org/0000-0001-7969-0515
  • Alexandre Leme Godoy dos Santos Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil https://orcid.org/0000-0002-6672-1869
  • Túlio Diniz Fernandes Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil https://orcid.org/0000-0002-9687-7143
Keywords: Arthritis, rheumatoid, Forefoot, human, Arthroplasty, Quality of life

Abstract

Objective: To evaluate the functional outcome and quality of life of patients with rheumatoid arthritis (RA) who underwent resection arthroplasty of the first to fifth metatarsal heads. Methods: Prospective case series study in which 8 feet of 5 patients underwent resection arthroplasty of the five metatarsal heads via a plantar
approach to the lateral rays and via a medial approach to the first metatarsal. Dressing and orthotics were used for 3 months to correct the position of the toes. Patients were evaluated in the preoperative period and at least one year after the procedure using two functional evaluation scales (AOFAS lesser toes and AOFAS hallux) and one quality of life scale (EQ-5D). All results were subjected to statistical validation using the
Mann-Whitney U test. Results: The subjects had a mean age of 71 years, with a prevalence of the female gender. The mean AOFAS lesser toe and AOFAS hallux scores increased from 38.6 and 24.5 preoperatively to 85.7 and 83.1 postoperatively, respectively (p<0.001). The quality of life scores measured through the EQ-5D improved from 8.0 to 5.6, on average. Conclusion: Resection arthroplasty of the five metatarsal heads improves the function and quality of life in the short term of patients with rheumatoid foot.
Level of Evidence IV; Therapeutic Studies; Case Series.

Published
30-12-2018
How to Cite
Macedo, R., Pires, E., Sposeto, R., Sakaki, M., Santos, A., & Fernandes, T. (2018). Surgical treatment of rheumatoid forefoot. Scientific Journal of the Foot & Ankle, 12(4), 310-15. https://doi.org/10.30795/scijfootankle.2018.v12.843