title: [The long-term result of implant arthroplasty for hallux valgus deformity in rheumatoid arthritis].
abstract: We have reviewed the results of reconstruction of the forefoot in rheumatoid patients with arthroplasty using a Swanson flexible hinge toe implant for the great toe and with resection arthroplasty for the lateral four toes. The follow-up averaged 8 years (range, 5-11 years). All patients were female and an average age was 52 (range, 31-72 years). Preoperative and postoperative hallux valgus angle (HVA), the angles between the axes of the first and second metatarsal shafts (M1-M2) and the first and fifth metatarsal shafts (M1-M5) were measured radiographically. Breakage of the implant and radiolucencies around the implant on X-ray were evaluated. Preoperative average HVA, M1-M2 and M1-M5 were 31, 10, and 30 respectively. Postoperative average HVA, M1-M2, and M1-M5 were 17, 10, and 28 respectively. Breakage of the implant was present in 77% of the feet and the radiolucencies around the implant was present in 63% of the feet. Although only one foot was performed revision surgery for severe pain and breakage of the implant, more than 95% of the feet obtained pain relief. We found that this type of operation was very effective in relieving pain in rheumatoid patients.
authors.affiliation: Department of Orthopaedic Surgery, School of Medicine Kobe University, Hyogo.
authors.forename: H
authors.initials: H
authors.lastname: Fujioka
authors.forename: M
authors.initials: M
authors.lastname: Doita
authors.forename: R
authors.initials: R
authors.lastname: Saura
authors.forename: K
authors.initials: K
authors.lastname: Mizuno
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications*; D019643:Arthroplasty, Replacement / Q000379:methods*; D019544:Equipment Failure Analysis; D005260:Female; D005500:Follow-Up Studies; D006215:Hallux Valgus / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome