ASSESSMENT OF PLANTAR PRESSURE DISTRIBUTION DURING WALKING AFTER FOREFOOT SURGERY IN PATIENTS WITH RHEUMATOID ARTHRITIS

Background: In rheumatoid arthritis (RA) patients, (1) hallux MTP-joint arthroplasty (Swanson implant)+2-5 toes metatarsal head resection arthroplasty and (2) hallux Scarf osteotomy+2-5 toes metatarsal shortening osteotomy are both standard methods. Objectives: The objective of this study is to investigate the unknown difference of operation (1) and (2) on plantar pressure distribution during walking. Methods: 3-feet of healthy volunteer (3 male / age 44.7y / body mass index [BMI] 20.2kg/m), 12 feet of RA patients with operation (1) (3 male 9 female / age 62.4y / postoperation duration 6.8y / standing leg-heel angle [S-LHA]1.3° / BMI 20.8kg/m), and 13 feet of RA patients with operation (2) (13 female / age 62.0y / postoperation duration 3.9y / S-LHA 0.5° / BMI 20.4kg/m) were enrolled. Average plantar pressure during walking through 2 to 6 steps was assessed by F-SCANⅡ® (Tekscan Inc.). Results: There was no significant difference in age, postoperation duration, S-LHA, and BMI between group (1) and (2). Plantar pressure distribution of hallux MTP-joints was 13.1% in healthy volunteer / operation (1) 7.0% / operation (2) 10.6%, and was significantly small in operation (1) compared to healthy volunteer (P<0.001) and to operation (2) (P<0.01). On the other hand, Plantar pressure distribution of 2-5 toes MTP-joints was 19.2% in healthy volunteer / operation (1) 20.4% / operation (2) 12.4%, and was significantly small in operation (2) compared to healthy volunteer and to operation (1) (P<0.01). Image/graph: Conclusions: Swanson implant arthroplasty of hallux MTP-joints may decrease plantar pressure distribution of MTP-joints compared to hallux Scarf osteotomy, and 2-5 toes metatarsal head resection arthroplasty may increase plantar pressure distribution of MTP-joints compared to 2-5 toes metatarsal shortening osteotomy. Disclosure of Interest: None DeclaredCitation: , volume 72, supplement s3, year 2013, page Session: Poster session Saturday ( )