Changes in foot function, disease activity, and disability after forefoot resection arthroplasty in patients with rheumatoid arthritis.

The purpose of this study was to investigate the changes in foot function, disease activity, and disability in patients with RA after resection arthroplasty of the forefoot (arthroplasty). Arthroplasty was performed on 11 patients with RA. All study patients underwent clinical assessment to measure disease activity (Disease Activity Score in 28 Joints-C-reactive protein, DAS28-CRP), disability (Health Assessment Questionnaire-Disability Index, HAQ-DI) and foot function (Foot Function Index, FFI) at the following stages: preoperatively and 1, 3, and 12 months after surgery. Following arthroplasty, foot function improved significantly, as assessed by FFI total and subscales (pain, disability, and limitation of activity) (P<0.001, P<0.001, P<0.001, and P=0.002, respectively). Disease activity was significantly improved in relation to DAS28-CRP and its subscales of number of swollen joints and patient global assessment (PtGA) (P=0.033, P=0.008, and P=0.038, respectively). There was no significant difference in disability, as assessed by the HAQ-DI and its subscale, HAQ-walking (P=0.150 and P=0.597, respectively). Foot function improved significantly after arthroplasty, and was maintained at 12 months postoperatively. Additionally, our study showed that disease activity and its subscale PtGA improved after arthroplasty.

A case of femoral nerve palsy caused by iliopectineal bursitis associated with rheumatoid arthritis.

We report the case of a 46-year-old woman with rheumatoid arthritis who developed femoral nerve palsy caused by an enlarged iliopectineal bursa. Surgical excision revealed that the iliopectineal bursa was connected with the hip joint. The patient showed good recovery from the femoral nerve palsy after surgery. It was considered that iliopectineal bursitis had developed following the synovial inflammation of the hip joint.