Effects of forefoot arthroplasty on plantar pressure, pain, gait and disability in rheumatoid arthritis

Mod Rheumatol. 2020 Mar;30(2):301-304. doi: 10.1080/14397595.2019.1584951. Epub 2019 Apr 5.

Abstract

Objectives: The purpose of this study was to clarify the effect of forefoot arthroplasty on plantar pressure, pain, gait, and disability within 1 year after arthroplasty in patients with RA.Methods: Eleven patients with RA who underwent forefoot arthroplasty completed this quasi-experimental study. Outcome measures were in-shoe plantar pressure, visual analog scale (VAS) for pain, temporal gait parameters, and modified Health Assessment Questionnaire (mHAQ), obtained preoperatively and at 4 and 12 months postoperatively.Results: The average peak plantar pressure under the 2nd metatarsal head decreased at 4 months postoperatively, compared to preoperative values (p < .05) and the decreased plantar pressure was sustained at 12 months postoperatively. Similar changes were observed under the 3rd to 5th metatarsal heads. The median VAS for foot pain decreased from 25 mm preoperatively to 1 mm at 4 months postoperatively and the lower score was sustained at 12 months postoperatively (p < .05). The median mHAQ score remained lower (<1.0) at all measurement points. Regarding gait, there were no significant differences from the preoperative assessment to postoperative follow-up.Conclusion: Plantar pressure and forefoot pain decreased at 4 and 12 months after forefoot arthroplasty in patients with RA. No adverse effects on gait parameters or disability were observed.

Keywords: Rheumatoid arthritis; arthroplasty; plantar pressure.

MeSH terms

  • Adult
  • Arthritis, Rheumatoid / surgery*
  • Arthroplasty / adverse effects*
  • Female
  • Forefoot, Human / surgery*
  • Gait*
  • Humans
  • Male
  • Metatarsal Bones / surgery
  • Middle Aged
  • Pain Measurement
  • Postoperative Complications / epidemiology*