Arthroscopic elimination of monosodium urate deposition of the first metatarsophalangeal joint reduces the recurrence of gout.
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.
Wang
Chih-Chien
CC
Department of Orthopaedic Surgery, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.
Lien
Shiu-Bii
SB
Huang
Guo-Shu
GS
Pan
Ru-Yu
RY
Shen
Hsain-Chung
HC
Kuo
Chun-Lin
CL
Shen
Pei-Hung
PH
Lee
Chian-Her
CH
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
D006074:Gout Suppressants; D014527:Uric Acid