Resection Arthroplasty: Current Indications and Tips

• Published in: Foot and ankle clinics Vol. 24; no. 4; pp. 689 - 693
• Main Authors: Guzman, Javier Z, Vulcano, Ettore
• Format: Journal Article
• Language: English
• Published: United States 01-12-2019
• Subjects: Arthritis, Rheumatoid - complications; Arthritis, Rheumatoid - surgery; Arthroplasty - methods; Foot Deformities, Acquired - etiology; Foot Deformities, Acquired - surgery; Forefoot, Human - surgery; Humans; Metatarsalgia - surgery; Metatarsophalangeal Joint - surgery; Plantar foot pain; Metatarsalgia; Resection arthroplasty; Rheumatoid arthritis
• ISSN: 1558-1934
• DOI: 10.1016/j.fcl.2019.08.005

Resection arthroplasty for metatarsalgia is a selective procedure primarily indicated for patients with rheumatoid arthritis. These patients present with significant forefoot deformities, poor bone quality, and loss of soft tissue integrity. Resection of the metatarsal heads and correction of lesser toe deformities improve pain and decrease transfer metatarsalgia. Patients with concurrent hallux valgus may benefit from a lapidus procedure or hallux metatarsophalangeal fusion in an effort to improve outcomes and decrease incidence of recurrent hallux valgus. In rare cases, diabetics with neuropathy may require resection arthroplasty in the setting of forefoot deformities recalcitrant to other modalities.