Efficacy Of The First Metatarsophalangeal Joint Resectio-n Arthroplasty Versus Arthrodesis For Rheumatoid Fore-foot Deformity:a Meta-analysis

Objective: To evaluate the efficacy of the first metatarsophalangeal joint Arthrodesisversus Resection Arthroplasty for Rheumatoid forefoot deformity. Methods: According toCochrane Reviews,Cochrane library(Issue3,2011),Ovid(from1996to june2012)PubMed(from January1990to June2012)CNKI(from January1990to June2012),MEDLINE(fron1966to June2012), CBM、EMBASE(from1966to June2012)andWanFang Data(from January1990to June2012)were searched for randomized controlledtrials(RCTs) comparing first metatarsophalangeal joint Arthrodesis versus ResectionArthroplasty for Rheumatoid forefoot deformity.Software RevMan5.1was used toanalyze the trials included in terms of patient satisfaction,hallux areaweight-bearing,AOFAS score,FFI score,HAV angle,IMA angle,operative time andcomplications.Results: The total5RCTs were included. Among the285patients involvedin this systematic review,The results of meta-analyses showed that the efficacy of theArthrodesis group was superior to that of the Arthroplasty group in Footwear (MD=-0.88,95%CI (-1.55,-0.22), P=0.01) and Alignment (MD=-5.04,95%CI(-8.94-1.14), P=0.01)with significant differences;it also has an advantage of IMA and HAV anglecorrection(MD=1.43,95%CI(0.37,2.48),P=0.008;MD=13.27,95%CI(11.44-15.09),P<0.00001) and significantly fewer complications(OR=2.32,95%CI(1.06,5.05), P=0.03) There wasno significant difference between the two groups in Patient satisfaction and FFI score.Conclusion: The first metatarsophalangeal joint Arthrodesis and2-5toe metatarsal headresection arthroplasty can effectively relieve pain and improve foot appearance andfunction, fewer complications.and is an ideal choice.