Comparison of bioreplaceable interposition arthroplasty with metatarsal head resection of the rheumatoid forefoot

Foot Ankle Int. 2010 Jun;31(6):505-10. doi: 10.3113/FAI.2010.0505.

Abstract

Background: Interposition arthroplasty with bioreplaceable poly-L/D-lactic acid (PLDLA) implants has been studied in Finland with promising results in reconstruction of the rheumatoid hand. We evaluated this material in a series of patients with rheumatoid forefoot deformities.

Materials and methods: Thirty-five patients were randomized to either PLDLA metatarsophalangeal joint interposition arthroplasty group (16 patients) or to conventional metatarsal head resection group (19 patients).

Results: At 3 months after surgery, the function VAS was significantly better in the control group (p = 0.003). The difference disappeared by 12 months. Otherwise, comparison between the two groups did not reveal any statistically significant differences in the AOFAS scores or the pain VAS at 3 or 12 months.

Conclusion: Early results after PLDLA interposition arthroplasty of metatarsophalangeal joints were not as promising as previously reported with rheumatoid metacarpophalangeal reconstruction.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Absorbable Implants*
  • Aged
  • Arthritis, Rheumatoid / physiopathology
  • Arthritis, Rheumatoid / surgery*
  • Arthroplasty, Replacement / methods*
  • Female
  • Forefoot, Human / diagnostic imaging
  • Forefoot, Human / physiopathology
  • Forefoot, Human / surgery*
  • Humans
  • Male
  • Metatarsal Bones / diagnostic imaging
  • Metatarsal Bones / surgery*
  • Middle Aged
  • Osteogenesis
  • Pain Measurement
  • Polyesters*
  • Prospective Studies
  • Radiography
  • Surgical Wound Infection

Substances

  • Polyesters
  • poly(lactide)