Abstract
Recently, disease modifying anti-rheumatic drugs and biologic agents have caused a paradigm shift in the treatment of rheumatoid arthritis (RA). Consequently, improved medical control of joint destruction has led us to reconsider the benefits of joint preservation. With good perioperative medical management of RA, surgical repositioning of the metatarsophalangeal (MTP) joints by metatarsal shortening and consequent relaxation of surrounding soft tissue is considered to be successful. This provides longitudinal decompression of the ray without tendon lengthening. This is beneficial for the joint's range of motion and for improving gait. It can be performed preferentially in the early-to-intermediate disease stages, instead of a joint-sacrificing procedure. The author would like to introduce this technique and the outcomes of joint-preserving surgery by CMOS involving three different proximal osteotomies for forefoot deformities in patients with RA.
