Triple osteotomy for erosive first metatarsal in a patient with rheumatoid arthritis: a case report.
Haruki TobimatsuKatsunori IkariKoichiro YanoKen OkazakiPublished in: Modern rheumatology case reports (2020)
Recently, over the half of the patients with rheumatoid arthritis achieved clinical remission with beneficial effects of disease modifying anti-rheumatic drugs, including biological disease modifying anti-rheumatic drugs. Because the patients in remission should have no/reduced progression of joint damage, there is a trend towards joint-preserving surgery in the treatment of rheumatoid forefoot deformities. Here we report a 76-year-old woman with rheumatoid arthritis developed a severe forefoot deformity including a large bony erosion of the first metatarsal head. She showed near remission for rheumatoid arthritis without having clinically active synovitis in her MTP joints. To preserving her metatarsophalangeal joint, a double first metatarsal osteotomy was planned to remove the bony erosion and simultaneously correct the hallux valgus. Thirty-month follow-up demonstrated excellent radiographical and patient-reported outcomes. To the best of our knowledge, this is the first case of a double first metatarsal osteotomy to remove the bony erosion and simultaneously correct the hallux valgus in a patient with rheumatoid arthritis with a large erosion of the first metatarsal head.
Keyphrases
- rheumatoid arthritis
- disease activity
- patient reported outcomes
- rheumatoid arthritis patients
- ankylosing spondylitis
- total knee arthroplasty
- interstitial lung disease
- systemic lupus erythematosus
- end stage renal disease
- case report
- ejection fraction
- healthcare
- newly diagnosed
- minimally invasive
- chronic kidney disease
- oxidative stress
- optic nerve
- peritoneal dialysis
- smoking cessation
- coronary artery bypass
- acute coronary syndrome
- atrial fibrillation
- idiopathic pulmonary fibrosis