Chapter

Surgical approach to the lower limb in rheumatoid arthritis

Hemant Pandit, Bob Sharp and Roger Gundle

in Rheumatoid Arthritis

Published on behalf of Oxford University Press

ISBN: 9780199556755
Published online May 2011 | e-ISBN: 9780199607334 | DOI: http://dx.doi.org/10.1093/med/9780199556755.003.0011

Series: Oxford Rheumatology Library

Surgical approach to the lower limb in rheumatoid arthritis

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• Total hip and knee replacement (THR and TKR) are both very successful operations to relieve pain and improve function • Prostheses should usually be cemented because poor bone stock may not support cementless fixation • The risk of post operative sepsis is about twice as high in RA compared with osteoarthritis • The aim of forefoot management is to optimize comfort and function and to minimize the risk of skin breakdown or ulceration • Fusion of the first MTP joint and excision of the metatarsal heads for the patients suffering advanced forefoot disease leads to a very high level of patient satisfaction • Management options for patients with stiffened arthritic mid-foot joints include orthotics, shoe wear, analgesia and walking aids; surgery is rarely required • Many patients present with inflammation around the tendons particularly of the hind foot, which if untreated, may lead to rupture.

Chapter.  2787 words.  Illustrated.

Subjects: Rheumatology

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