Hindfoot surgery for rheumatoid arthritis

  • B. Valtin
  • Th. Leemrijse


Rheumatoid arthritis is a common condition with an incidence ranging from 0.5 to 1.5%. Involvement of the foot and of the ankle depends upon the duration of the disease and will be present in 50% of patients at 10 years and 75% at 20 years (8). Different authors have variably described the frequency of involvement of the subtalar and midtarsal joints during the progressive course of rheumatoid arthritis. These joints were affected in 67% of cases in Vainio’s study (11) of 995 cases, while King and Freeman reported a more modest incidence of 30% (4). This difference could be attributed to the relatively mild clinical symptoms or to the relatively common radiological changes in the subtalar joint complex. In fact, these radiological changes are frequently seen in the subtalar, talo-navicular and calcaneocuboid joints during the evolution of rheumatoid arthritis although remaining clinically silent for a long time. In fact, Vigidal found radiological disturbances to be twice as frequent as clinical symptoms in the mid-foot and three times more often at the sub-talar joint. In his prospective study of 99 patients that fulfilled the criteria of the American College of Rheumatology, Michelson (8) found involvement of the ankle in 42% of cases, of the forefoot in 28%, of the midfoot in 5% and of the heel in 1%. This wide disparity in results reflects the differences in criteria of appreciation that should be correlated to other criteria such as the functional capacity of the patient and the duration of the disease. Numerous studies have also emphasized the insufficiency of preventive measures employed and of the quality of footwear, which should constitute the primary treatment of the rheumatoid foot.


Rheumatoid Arthritis Articular Surface Lateral Malleolus Valgus Deformity Talonavicular Joint 


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Copyright information

© Springer Verlag France 2006

Authors and Affiliations

  • B. Valtin
    • 1
  • Th. Leemrijse
    • 2
  1. 1.Clinique des Lilas CEPIMLes LilasFrance
  2. 2.Cliniques Universitaires Saint-LucBruxellesBelgium

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