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MODERN RHEUMATOLOGY Vol.14 No.2

>MR14-2

Partial tarsal arthrodesis for rheumatoid feet
Yasuhito Tanaka1 , Yoshinori Takakura1, Akira Taniguchi1, Kazuya Sugimoto1, Tsukasa Kumai1 and Akihiro Fukui1
(1) Department of Orthopaedic Surgery, Nara Medical University, Kashihara, 634-8522, Japan
Received: 30 May 2003 Accepted: 19 August 2003


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Abstract

 Partial intertarsal joint arthrodesis was performed on 12 feet of 11 patients as a surgical treatment for planovalgus deformity of the foot and lesions of the intertarsal joints caused by rheumatoid arthritis. Single arthrodesis was performed on the talocalcaneal joint in eight feet, two of which underwent simultaneous total ankle arthroplasty, and on the talonavicular joint in two feet. Double arthrodesis was done on the talocalcaneal and talonavicular joints in one foot and on the talonavicular and calcaneocuboid joints in one foot. Screws or staples were used for fixation. Patients were followed for 2 years to 8 years 7 months (average 4 years 3 months). Osseous fusion was achieved in all feet, and satisfactory pain relief was obtained in all cases except one. We performed this surgery in patients who were relatively active, and the results indicated that arthrodesis of a small number of joints that caused pain and deformity was effective in reducing pain and correcting the deformity. We concluded that partial tarsal arthrodesis should be performed on a limited number of joints during the early stages of planovalgus deformity of the foot because more joints are found to be fixed during the advanced stages. However, progression of the osteoarthritis was found in the neighboring joints. Close follow-up observation is needed.
 
Key words
Arthrodesis - Intertarsal joint - Rheumatoid arthritis - Talocalcaneal joint - Talonavicular joint
 
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