Rheumatoid Forefoot Reconstruction Following Minimally Invasive Surgery and Hoffmann-Clayton Procedure with Administration of Plasma Rich in Growth Factors - A 3-Year Follow-Up: A Retrospective Study; [Reconstrucción del antepié reumatoide después de una cirugía mínimamente invasiva y un procedimiento de Hoffmann-Clayton con administración de plasma rico en factores de crecimiento - Seguimiento de 3 años: Estudio retrospectivo]

From 80 % to 90 % of foot deformities in adults are due to rheumatoid arthritis. Despite various surgical approaches, early functional and cosmetic results have been the greatest concern among patients. Thus, optimal surgical choice in rheumatoid forefoot correction is of vital importance for better subjective and clinical results. Our work evaluates the results of minimally invasive surgery (MIS) and resection arthroplasty per Hoffmann-Clayton along with the administration of Plasma Rich in Growth Factors (PRGF) in rheumatoid-affected forefoot patients. This retrospective study included 28 patients (50 feet) aged around 45 ± 4.5 years. The examination was made for the following parameters: pain, insoles, ambulant, function of the foot, recurrence rate and revision surgery, and patient comfort. Though the function of the forefoot was quite challenging to assess, the ability to wear conventional shoes had been increased to 70 %. The patients could walk more distances with shoes rather than walking without shoes (P<0.01). Seventeen reoperations were carried out on 12 patients. The recurrence rate had been too minimal which was common for hallux valgus cases. The results of 3 years follow-up of patient-reported questionnaires demonstrated that a large number of patients (more than 80 %) were significantly satisfied. Especially, PRGF favours the treatment by minimizing the rehabilitation period, post-operative edema, pain, and better cosmesis. © 2022 Academia Nacional de Medicina. All rights reserved.