title: Recurrence of deformity after silicone implant and resection arthroplasty of the metatarsophalangeal joint for rheumatoid arthritis: long-term results.
abstract: OBJECTIVE
  To examine the recurrence of deformity after silicone implant arthroplasty combined with resection arthroplasty for severe forefoot deformity in patients with rheumatoid arthritis.
  
  
  METHODS
  We reviewed the long-term results of this procedure for 27 feet in 15 patients. Their average age and disease duration at the time of operation were 58.6 years and 17.5 years, respectively, and the average follow-up period was 10.3 years.
  
  
  RESULTS
  An improved hallux valgus angle (45.3° preoperatively, 23.6° 6 months after operation) was maintained. By contrast, deformity and dislocation of lesser toe had recurred at the final follow-up; the angle between the proximal phalanx and the metatarsal of the second toe improved 13.4° with recurrence of 22.5°, the angle between the proximal phalanx and ground surface improved 22.4° with recurrence of 34.5. Furthermore, claw toe deformity at the final follow-up was significantly worse in the group whose hallux valgus deformity was observed 6 months after operation.
  
  
  CONCLUSIONS
  This procedure could maintain the alignment of the first metatarsophalangeal joint, but the recurrence of claw toe deformity is a problem and the relation between the first toe and the lesser toe is an important consideration.
authors.affiliation: a Department of Orthopaedics, Graduate School of Medical Science , Kyoto Prefectural University of Medicine , Kamigyo-Ku , Kyoto , Japan and.
authors.forename: Daigo
authors.initials: D
authors.lastname: Taniguchi
authors.affiliation: a Department of Orthopaedics, Graduate School of Medical Science , Kyoto Prefectural University of Medicine , Kamigyo-Ku , Kyoto , Japan and.
authors.forename: Ryo
authors.initials: R
authors.lastname: Oda
authors.affiliation: a Department of Orthopaedics, Graduate School of Medical Science , Kyoto Prefectural University of Medicine , Kamigyo-Ku , Kyoto , Japan and.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Ikoma
authors.affiliation: a Department of Orthopaedics, Graduate School of Medical Science , Kyoto Prefectural University of Medicine , Kamigyo-Ku , Kyoto , Japan and.
authors.forename: Shogo
authors.initials: S
authors.lastname: Toyama
authors.affiliation: a Department of Orthopaedics, Graduate School of Medical Science , Kyoto Prefectural University of Medicine , Kamigyo-Ku , Kyoto , Japan and.
authors.forename: Ryota
authors.initials: R
authors.lastname: Takatori
authors.affiliation: a Department of Orthopaedics, Graduate School of Medical Science , Kyoto Prefectural University of Medicine , Kamigyo-Ku , Kyoto , Japan and.
authors.forename: Kan
authors.initials: K
authors.lastname: Imai
authors.affiliation: a Department of Orthopaedics, Graduate School of Medical Science , Kyoto Prefectural University of Medicine , Kamigyo-Ku , Kyoto , Japan and.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Hara
authors.affiliation: b Department of Rehabilitation Medicine , Kyoto Prefectural University of Medicine , Kyoto , Japan.
authors.forename: Koshiro
authors.initials: K
authors.lastname: Sawada
authors.affiliation: a Department of Orthopaedics, Graduate School of Medical Science , Kyoto Prefectural University of Medicine , Kamigyo-Ku , Kyoto , Japan and.
authors.forename: Daisaku
authors.initials: D
authors.lastname: Tokunaga
authors.affiliation: a Department of Orthopaedics, Graduate School of Medical Science , Kyoto Prefectural University of Medicine , Kamigyo-Ku , Kyoto , Japan and.
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Fujiwara
authors.affiliation: a Department of Orthopaedics, Graduate School of Medical Science , Kyoto Prefectural University of Medicine , Kamigyo-Ku , Kyoto , Japan and.
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Kubo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000601:surgery*; D001178:Arthroplasty / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006215:Hallux Valgus / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008682:Metatarsal Bones / Q000000981:diagnostic imaging / Q000601:surgery; D008683:Metatarsophalangeal Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D019736:Prostheses and Implants; D011859:Radiography; D012008:Recurrence; D012828:Silicones; D016896:Treatment Outcome
chemical_list: D012828:Silicones
keywords: Forefoot; Long-term results; Rheumatoid arthritis; Surgery