title: Arthroscopic elimination of monosodium urate deposition of the first metatarsophalangeal joint reduces the recurrence of gout.
abstract: OBJECTIVE
  To determine if the arthroscopic removal of gouty crystal deposits from the first metatarsophalangeal (MTP) joint will reduce the recurrence rate and improve foot function compared to medical treatment alone.
  
  
  METHODS
  Twenty-eight male patients with hyperuricemia (>7.0 mg/dL) and repeated attacks of gouty arthritis of the first MTP joint were included in this study. Arthroscopic intervention of the first MTP joint was performed on 15 patients (group 1), while the other 13 patients were treated with medication alone (group 2). The follow-up period (mean +/- standard deviation) was 3.9 +/- 1.1 years in group 1 and 2.4 +/- 0.3 years in group 2.
  
  
  RESULTS
  After treatment, both groups showed a significant improvement in the number of acute attacks of gouty arthritis and in their functional scores on the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale. On both measures, the results for group 1 were significantly better than those for group 2.
  
  
  CONCLUSIONS
  Arthroscopic removal of gouty crystals from the first MTP joint can reduce the rate of acute repeated attacks of gouty arthritis and increase foot and ankle function.
authors.affiliation: Department of Orthopaedic Surgery, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Chih-Chien
authors.initials: CC
authors.lastname: Wang
authors.forename: Shiu-Bii
authors.initials: SB
authors.lastname: Lien
authors.forename: Guo-Shu
authors.initials: GS
authors.lastname: Huang
authors.forename: Ru-Yu
authors.initials: RY
authors.lastname: Pan
authors.forename: Hsain-Chung
authors.initials: HC
authors.lastname: Shen
authors.forename: Chun-Lin
authors.initials: CL
authors.lastname: Kuo
authors.forename: Pei-Hung
authors.initials: PH
authors.lastname: Shen
authors.forename: Chian-Her
authors.initials: CH
authors.lastname: Lee
mesh_terms: D000328:Adult; D015210:Arthritis, Gouty / Q000188:drug therapy / Q000517:prevention & control / Q000601:surgery*; D001182:Arthroscopy / Q000379:methods*; D016025:Bone Transplantation; D003646:Debridement / Q000379:methods*; D005500:Follow-Up Studies; D006074:Gout Suppressants / Q000627:therapeutic use; D006801:Humans; D033461:Hyperuricemia / Q000150:complications; D008297:Male; D008683:Metatarsophalangeal Joint / Q000737:chemistry / Q000601:surgery*; D008875:Middle Aged; D020127:Recovery of Function; D012008:Recurrence; D012720:Severity of Illness Index; D014527:Uric Acid / Q000378:metabolism*; D055815:Young Adult
chemical_list: D006074:Gout Suppressants; D014527:Uric Acid