Comparison of bioreplaceable interposition arthroplasty with metatarsal head resection of the rheumatoid forefoot.
BACKGROUND
Interposition arthroplasty with bioreplaceable poly-L/D-lactic acid (PLDLA) implants has been studied in Finland with promising results in reconstruction of the rheumatoid hand. We evaluated this material in a series of patients with rheumatoid forefoot deformities.


METHODS
Thirty-five patients were randomized to either PLDLA metatarsophalangeal joint interposition arthroplasty group (16 patients) or to conventional metatarsal head resection group (19 patients).


RESULTS
At 3 months after surgery, the function VAS was significantly better in the control group (p = 0.003). The difference disappeared by 12 months. Otherwise, comparison between the two groups did not reveal any statistically significant differences in the AOFAS scores or the pain VAS at 3 or 12 months.


CONCLUSIONS
Early results after PLDLA interposition arthroplasty of metatarsophalangeal joints were not as promising as previously reported with rheumatoid metacarpophalangeal reconstruction.
Tiihonen
Raine
R
Rheumatism Foundation Hospital, FI-18120 Heinola, Finland. raine.tiihonen@phsotey.fi
Skyttä
Eerik T
ET
Eerik
Skyttä
S
Ikävalko
Mikko
M
Kaarela
Kalevi
K
Kalevi
Kaarela
K
Belt
Eero
E
Eero
Belt
B
D020341:Absorbable Implants; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000503:physiopathology / Q000601:surgery*; D019643:Arthroplasty, Replacement / Q000379:methods*; D005260:Female; D005545:Forefoot, Human / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008682:Metatarsal Bones / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D010012:Osteogenesis; D010147:Pain Measurement; D011091:Polyesters; D011446:Prospective Studies; D011859:Radiography; D013530:Surgical Wound Infection
D011091:Polyesters; C033616:poly(lactide)