Rheumatology: Current Research
Open Access

Tendon Transfer in Rheumatoid Foot Reconstruction

Marcello Govoni^{* *}Correspondence: Marcello Govoni, Department of Rheumatology, University of Ferrara, Ferrara, Italy, Email:

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About the Study

Rheumatoid Arthritis (RA) is a chronic autoimmune disease that affects the joints and can lead to severe deformities of the foot. These deformities can cause pain, difficulty walking, and decreased mobility. Tendon transfer is a surgical technique used in rheumatoid foot reconstruction to restore function and improve mobility. This procedure involves moving a healthy tendon from one part of the foot to another to replace a damaged or non-functioning tendon.

Benefits

The primary benefit of tendon transfer in rheumatoid foot reconstruction is the restoration of function. By transferring a healthy tendon, the foot's muscles can be repositioned, allowing the patient to walk more efficiently and without pain. The transfer can also help to correct deformities, such as claw toes or flat feet, and improve the overall appearance of the foot. Another benefit of tendon transfer is that it can prevent or delay the need for more invasive surgeries, such as joint fusion or joint replacement.

These surgeries can be more complex and require longer recovery times. Tendon transfer is a relatively straightforward procedure that can be done on an outpatient basis, with most patients returning to work within a few weeks.

Risks

As with any surgical procedure, there are risks associated with tendon transfer. These risks can include infection, bleeding, and nerve damage. In rare cases, the transferred tendon may not function correctly, or the patient may experience a loss of mobility or sensation.

Recovery

Recovery from tendon transfer can vary depending on the extent of the surgery and the patient's overall health. In general, patients can expect to wear a cast or brace for several weeks after surgery to allow the transferred tendon to heal properly. Physical therapy is also an essential part of the recovery process, as it helps to strengthen the foot muscles and restore function.

Anatomy of the foot in rheumatoid arthritis: To understand the role of tendon transfer in rheumatoid foot reconstruction, it is important to first understand the anatomy of the foot in rheumatoid arthritis. RA can cause damage to the tendons, ligaments, and joints in the foot, leading to deformities and loss of function. Common deformities include claw toes, flat feet, and bunions.

Indications for tendon transfer: Tendon transfer is indicated for patients who have lost function in one or more tendons due to rheumatoid arthritis. It may also be used to correct deformities or improve the appearance of the foot. Tendon transfer is usually considered when other conservative treatments, such as medication or physical therapy, have been unsuccessful.

Preoperative evaluation and planning: Before undergoing tendon transfer surgery, patients will undergo a preoperative evaluation to assess their overall health and determine the best course of treatment. This evaluation may include imaging studies, such as X-rays or MRI, to evaluate the extent of the damage and identify any underlying conditions that may affect the surgery's outcome.

Surgical technique: Tendon transfer surgery involves moving a healthy tendon from one part of the foot to another to replace a damaged or non-functioning tendon. The surgeon will make an incision in the foot and carefully detach the healthy tendon from its original location. The tendon is then repositioned and secured to the new location using sutures or other surgical techniques.

Postoperative care and rehabilitation: Following tendon transfer surgery, patients will need to rest and keep the foot elevated for several days to allow the tendon to heal properly. A cast or brace will also be applied to the foot to protect the tendon and keep it in place. Physical therapy will begin within a few weeks of surgery to help restore function and strength to the foot. This therapy may include exercises to improve range of motion, strengthen the foot muscles, and improve balance.

Complications and management

Although rare, complications can occur following tendon transfer surgery. These complications can include the infection, bleeding, and nerve damage. Patients should watch for signs of infection, such as redness, swelling, or drainage from the incision site, and report them to their doctor immediately. In cases where nerve damage occurs, the patient may experience numbness, tingling, or weakness in the foot. Physical therapy and other interventions can help manage these complications.

Prognosis and outcomes

The prognosis for patients who undergo tendon transfer surgery is generally good. Most patients experience significant improvement in function and mobility following the surgery. However, the outcomes can vary depending on the extent of the damage, the patient's overall health, and their adherence to postoperative care and rehabilitation.