RHEUMATOID REARFOOT Flashcards

1
Q

articular pathology

soft tissue pathology

relieve pain, improve
function

synovectomy

arthrodesis

joint replacement
-goal: plantigrade, nonpainful foot and ankle

these are indication for what type of pathology?

A

rheumatoid rearfoot

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2
Q

rearfoot fusion indications?

A

rheumatoid flatfoot
function loss due to deformity/instability
poor prognosis of joint
RA>non RA ankle OA

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3
Q

Glissans principles of arthrodesis?

A

removal of all cartilage, soft tissue
-subchondral bone

good apposition of fusion sites

optimum position

maintenance of position until fusion

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4
Q
RA=high risk patients
ankle valgus more common
ankle joint affected up to 50% RA patients
over 50% with RA over 13 years
slows down adjacent joint
A

total ankle arthroplasty in RA patient

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5
Q

wound healing issues up to 40% cases

malleolar fractures

malalignment

stiffness

infection with/without implant loosening

A

TAA (TAR) complications

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6
Q

charcot arthropathy complications?

A
delayed union/nonunion
vascular compromise
neurologic complications
tendon pathology
soft tissue pathology
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7
Q

complications encountered with RA surgical foot and ankle?

A

10% nonunion rate
5% lesser digit revision
20% infection

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8
Q

RA surgery complications can lead to?

A

deep vein thrombosis

  • long term steroid use
  • virchows triad
  • 2 aspirin
  • warfarin
  • enoxaparin
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9
Q

types of surgical intervention for the rheumatoid patient?

A
synovectomy
soft tissue release
arthrodesis
TAR
physical therapy
tx plan is unique
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10
Q

important considerations?

A

preoperative evaluation imperative

consult with rheumatologist

early attempts at synovectomy

modified hoffman and hoffman clayton

rearfoot fusions

watch for infection/delayed incision healing

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