Kates forefoot arthroplasty in rheumatoid arthritis. A 5-year followup study.

The longterm results of Kates forefoot arthroplasty in 74 feet of 41 patients with rheumatoid arthritis (RA) after a mean followup of 5.2 years was considered to be good by 38 patients and poor by 3 patients. The average walking distance had doubled. The mean hallux valgus angle was reduced from 46 to 27 degrees. Surgical results proved to depend on the quality of the arc of the remaining stumps, and not on the severity or activity of RA. Reoperations were necessary in 16 feet of 10 patients because of too prominent distal metatarsal stumps. Despite the absence of pain, 28 patients were not satisfied with the function of the hallux. This might be improved by performing arthrodesis of the first metatarsophalangeal joint.