Download PDF
Arthritis und Rheuma 2024; 44(04): 255-263
DOI: 10.1055/a-2279-6160
Schwerpunkt

Entzündlich-rheumatische Erkrankung des Vorfußes

Auswirkungen und Therapie
Sebastian Plöger
1   St. Josef Stift Sendenhorst, Sendenhorst
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

ZUSAMMENFASSUNG

Der Text beschreibt die Auswirkungen und Behandlungsmöglichkeiten der entzündlich-rheumatischen Erkrankung des Vorfußes, die zu chronischer Entzündung und Zerstörung der Gelenke und angrenzender Gewebe führt. Der Vorfuß ist bei vielen Rheumapatienten von Schmerzen betroffen, was oft zu einer erheblichen Einschränkung im Alltag führt. Trotz Fortschritten in der medikamentösen Therapie bleiben Fußprobleme ein herausforderndes Problem, da viele Patienten eine erosive Zerstörung der Gelenke zeigen. Die Behandlung erfordert einen interdisziplinären Ansatz aus orthopädischer und internistischer Rheumatologie, Orthopädietechnik und Physiotherapie. Ziel ist es, den Krankheitsprozess zu verlangsamen, Schmerzen zu reduzieren und die Lebensqualität zu verbessern. Operative Eingriffe werden bei fortgeschrittener Gelenkdestruktion in Betracht gezogen, um Schmerzen zu lindern und die Fußfunktion wiederherzustellen. Die Entscheidung für eine Operation hängt von verschiedenen Faktoren ab. Insgesamt stellt die Behandlung der entzündlich-rheumatischen Vorfußdestruktion eine komplexe Herausforderung dar, die eine enge Zusammenarbeit verschiedener medizinischer Fachrichtungen erfordert, um die bestmögliche Versorgung der Patienten zu gewährleisten.

Schlüsselwörter

Fußprobleme - Vorfuß - entzündlich-rheumatische Erkrankung - interdisziplinärer Ansatz - operative Eingriffe


Publication History

Article published online:
06 September 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • Literatur

  • 1 Brenton-Rule A, Dalbeth N, Menz HB. et al Are foot and ankle characteristics associated with falls in people with rheumatoid arthritis? A prospective study. Arthritis Care Res 2017; 69 (08) 1150-1155
    CrossrefPubMedGoogle Scholar
  • 2 Grondal L, Tengstrand B, Nordmark B. et al The foot: still the most important reason for walking incapacity in rheumatoid arthritis: distribution of symptomatic joints in 1000 RA patients. Acta Orthop 2008; 79 (02) 257-261
    CrossrefPubMedGoogle Scholar
  • 3 Wickman A, Pinzur M, Kadanoff R, Juknelis D. Health-related quality of life for patients with rheumatoid arthritis foot involvement. Foot and Ankle Inter 2004; 25 (01) 19-26
    CrossrefPubMedGoogle Scholar
  • 4 Matricali GA, Boonen A, Verduyckt J. et al The presence of forefoot problems and the role of surgery in patients with rheumatoid arthritis. Ann Rheum Dis 2006; 65: 1254-1255
    CrossrefPubMedGoogle Scholar
  • 5 Wilson O, Hewlett S, Woodburn J. et al Prevalence, impact and care of foot problems in people with rheumatoid arthritis: results from a United Kingdom based cross-sectional survey. J Foot Ankel Res 2017; 10: 46
    CrossrefPubMedGoogle Scholar
  • 6 Dixey J, Solymossy C, Young A. Early RA Study. Is it possible to predict radiological damage in early rheumatoid arthritis (RA)? A report on the occurrence, progression, and prognostic factors of radiological erosions over the first 3 years in 866 patients from the Early RA Study (ERAS). J Rheumatol Suppl 2004; 69: 48-54
    PubMedGoogle Scholar
  • 7 Belt EA, Kaarela K, Lehto MU. Destruction and arthroplasties of the metatarsophalangeal joints in seropositive rheumatoid arthritis. A 20-year follow-up study. Scand J Rheumatol 1998; 27 (03) 194-196
    CrossrefPubMedGoogle Scholar
  • 8 Brook A, Corbett M. Radiographic changes in early rheumatoid disease. Ann Rheum Dis 1977; 36 (01) 71-73
    CrossrefPubMedGoogle Scholar
  • 9 Hulsmans HM, Jacobs JW, van der Heijde DM. et al The course of radiologic damage during the first six years of rheumatoid arthritis. Arthritis Rheum 2000; 43 (09) 1927-1940
    CrossrefPubMedGoogle Scholar
  • 10 Bruynesteyn K, Landewé R, van der Linden S. D van der Heijde. Radiography as primary outcome in rheumatoid arthritis: acceptable sample sizes for trials with 3 months’ follow up. Ann Rheum Dis 2004; 63 (11) 1413-1418
    CrossrefPubMedGoogle Scholar
  • 11 Larsen A, Dale K, Eek M. Radiographic evaluation of rheumatoid arthritis and related conditions by standard reference films. Actas Radiol Diagn 1977; 18 (04) 481-491
    CrossrefPubMedGoogle Scholar
  • 12 Kushioka J, Hirao M, Tsuboi H. et al Modified Scarf Osteotomy with Medial Capsule Interposition for Hallux Valgus in Rheumatoid Arthritis: A Study of Cases Including Severe First Metatarsophalangeal Joint Destruction. J Bone Jt Surg Am 2018; 100 (09) 765-776
    CrossrefPubMedGoogle Scholar
  • 13 Bhavikatti M, Sewell MD, Al-Hadithy N. et al Joint preserving surgery for rheumatoid forefoot deformities improves pain and corrects deformity at midterm follow-up. Foot 2012; 22: 81-84
    CrossrefPubMedGoogle Scholar
  • 14 Shi K, Hayashida K, Tomita T. et al Surgical treatment of hallux valgus deformity in rheumatoid arthritis: clinical and radiographic evaluation of modified Lapidus technique. J Foot Ankle Surg 2000; 39 (06) 376-382
    CrossrefPubMedGoogle Scholar
  • 15 Niki H, Hirano T, Akiyama Y. et al Long-term outcome of joint-preserving surgery by combination metatarsal osteotomies for shortening for forefoot deformity in patients with rheumatoid arthritis. Mod Rheumatol 2015; 25 (05) 683-688
    CrossrefPubMedGoogle Scholar
  • 16 Etani Y, Hirao M, Ebina K. et al Combination of Modified Scarf Osteotomy and Metatarsal Shortening Offset Osteotomy for Rheumatoid Forefoot Deformity. Int J Environ Res Public Health 2021; 18 (19) 10473
    CrossrefPubMedGoogle Scholar
  • 17 Hyer CF, Morrow S. Successful arthrodesis of the first metatarsophalangeal joint in patients with inflammatory and noninflammatory arthritis: a comparative analysis. J Foot Ankle Surg 2014; 53 (03) 291-294
    CrossrefPubMedGoogle Scholar
  • 18 Politi J, John H, Njus G. et al First metatarsal-phalangeal joint arthrodesis: a biomechanical assessment of stability. Foot Ankle Int 2003; 24 (04) 332-337
    CrossrefPubMedGoogle Scholar
  • 19 Balu AR, Baumann AN, Terence Tsang T. et al Evaluating the Biomechanical Integrity of Various Constructs Utilized for First Metatarsophalangeal Joint Arthrodesis: A Systematic Review. Materials (Basel) 2023; 16 (19) 6562
    CrossrefPubMedGoogle Scholar
  • 20 Daniels TR, Younger ASE, Penner MJ. et al Midterm Outcomes of Polyvinyl Alcohol Hydrogel Hemiarthroplasty of the First Metatarsophalangeal Joint in Advanced Hallux Rigidus. Foot Ankle Int 2017; 38 (03) 243-247
    CrossrefPubMedGoogle Scholar
  • 21 Fieschi S, Saffarini M, Manzi L, Fieschi A. Mid-term outcomes of first metatarsophalangeal arthroplasty using the Primus FGT double-stemmed silicone implants. Foot Ankle Surg 2017; 23 (03) 142-147
    CrossrefPubMedGoogle Scholar
  • 22 Clough TM, Ring J. Silastic first metatarsophalangeal joint arthroplasty for the treatment of end-stage hallux rigidus. Bone Joint J. 2020 102-B(2) 220-226
    PubMedGoogle Scholar
  • 23 Trieb K, Hofstaetter SG, Panotopoulos J, Wanivenhaus A. The Weil osteotomy for correction of the severe rheumatoid forefoot. Int Orthop 2013; 37 (09) 1795-1798
    CrossrefPubMedGoogle Scholar
  • 24 Zaid HHG, Di W, Yang R. et al Surgical Management of Monoarticular Rheumatoid Arthritis of the Fifth Metatarsophalangeal Joint. Orthop Surg 2020; 12 (06) 1597-1604
    CrossrefPubMedGoogle Scholar
  • 25 Duan X, Yang L, Dai G, Peng X. Rheumatoid forefoot reconstruction with first metatarsophalangeal fusion and arthroplasty of lesser metatarsal heads. Chinese journal of reparative and reconstructive surgery 2012; 26 (04) 445-448
    PubMedGoogle Scholar
  • 26 Coughlin MJ. Rheumatoid forefoot reconstruction. A long-term follow-up study. J Bone Joint Surg Am 2000; 82 (03) 322-341
    CrossrefPubMedGoogle Scholar
  • 27 Mann RA, Schakel ME. Surgical correction of rheumatoid forefoot deformities. Foot Ankle Int 1995; 16 (01) 1-6
    CrossrefPubMedGoogle Scholar
  • 28 Mulcahy D, Daniels TR, Lau JT-C. et al Rheumatoid forefoot deformity: a comparison study of 2 functional methods of reconstruction. J Rheumatol 2003; 30 (07) 1440-1450
    Google Scholar