Kosuke Ebina1, Makoto Hirao1, Jun Hashimoto2, Akihide Nampei3, Kenrin Shi4, Tetsuya Tomita5, Kazuma Futai1, Yasuo Kunugiza6, Takaaki Noguchi1, Hideki Yoshikawa1. 1. a Department of Orthopaedic Surgery , Osaka University Graduate School of Medicine , Suita , Japan. 2. b Department of Rheumatology , National Hospital Organization, Osaka-Minami Medical Center , Kawachinagano-shi , Japan. 3. c Department of Orthopaedic Surgery , National Hospital Organization, Osaka-Minami Medical Center , Kawachinagano-shi , Japan. 4. d Department of Rheumatology , Yukioka Hospital , Osaka , Japan. 5. e Department of Orthopaedic Biomaterial Science , Osaka University Graduate School of Medicine , Suita , Japan , and. 6. f Department of Orthopaedic Surgery , Japan Community Healthcare Organization, Hoshigaoka Medical Center , Hirakata , Japan.
Abstract
OBJECTIVES: To clarify the difference of patient-based outcome between joint-preserving arthroplasty and resection-replacement arthroplasty in forefoot surgery for patients with rheumatoid arthritis (RA). METHODS: A total of 63 feet of 49 RA patients who underwent forefoot surgery were asked to answer pre-operative and post-operative self-administered foot evaluation questionnaire (SAFE-Q). Patients were treated with either (1) metatarsal head resection-replacement arthroplasty (28 feet, post-operative mean age 63.8 years, follow-up 4.2 years, DAS28-CRP 2.2) or (2) metatarsophalangeal joint-preserving arthroplasty (35 feet, post-operative mean age 63.1 years, follow-up 3.6 years, DAS28-CRP 2.1) at each surgeon's discretion. RESULTS: Mean pre-operative and post-operative subscale scores of SAFE-Q of group (1) and (2) were as follows. Pain and pain-related [(1) pre-op 36.8 to post-op 75.0 vs. (2) pre-op 42.2 to post-op 82.6], physical functioning and daily-living [(1) 43.2-68.8 vs. (2) 52.778.1], social functioning [(1) 44.3-72.0 vs. (2) 52.5-81.9], general health and well-being [(1) 48.4-68.4 vs. (2) 45.5-84.4], and shoe-related [(1) 30.1-50.3 vs. (2) 30.6-64.4]. Both general health and well-being subscale scores (p < 0.05) and shoe-related subscale scores (p < 0.05) were significantly more improved in group (2) compared with group (1). CONCLUSIONS: Joint-preserving arthroplasty resulted in better patient-based outcomes than resection-replacement arthroplasty.
OBJECTIVES: To clarify the difference of patient-based outcome between joint-preserving arthroplasty and resection-replacement arthroplasty in forefoot surgery for patients with rheumatoid arthritis (RA). METHODS: A total of 63 feet of 49 RApatients who underwent forefoot surgery were asked to answer pre-operative and post-operative self-administered foot evaluation questionnaire (SAFE-Q). Patients were treated with either (1) metatarsal head resection-replacement arthroplasty (28 feet, post-operative mean age 63.8 years, follow-up 4.2 years, DAS28-CRP 2.2) or (2) metatarsophalangeal joint-preserving arthroplasty (35 feet, post-operative mean age 63.1 years, follow-up 3.6 years, DAS28-CRP 2.1) at each surgeon's discretion. RESULTS: Mean pre-operative and post-operative subscale scores of SAFE-Q of group (1) and (2) were as follows. Pain and pain-related [(1) pre-op 36.8 to post-op 75.0 vs. (2) pre-op 42.2 to post-op 82.6], physical functioning and daily-living [(1) 43.2-68.8 vs. (2) 52.778.1], social functioning [(1) 44.3-72.0 vs. (2) 52.5-81.9], general health and well-being [(1) 48.4-68.4 vs. (2) 45.5-84.4], and shoe-related [(1) 30.1-50.3 vs. (2) 30.6-64.4]. Both general health and well-being subscale scores (p < 0.05) and shoe-related subscale scores (p < 0.05) were significantly more improved in group (2) compared with group (1). CONCLUSIONS: Joint-preserving arthroplasty resulted in better patient-based outcomes than resection-replacement arthroplasty.
Authors: Ana Belen Ortega-Avila; Antonio Moreno-Velasco; Pablo Cervera-Garvi; Magdalena Martinez-Rico; Esther Chicharro-Luna; Gabriel Gijon-Noqueron Journal: J Clin Med Date: 2019-12-24 Impact factor: 4.241
Authors: Koichiro Yano; Katsunori Ikari; Haruki Tobimatsu; Ayako Tominaga; Ken Okazaki Journal: Int J Environ Res Public Health Date: 2021-04-13 Impact factor: 3.390