AB0235 Polymorphisms of hla-drb1 and tnf-308 g/a are associated with radiographic joint destruction in patients with very early rheumatoid arthritis

I. Guseva, A. Smirnov, N. Demidova, M. Krylov, A. Avdeeva, E. Samarkina, E. Luchikhina, E. Karateev, D. Abramov, E. Nasonov
2018 Rheumatoid arthritis – prognosis, predictors and outcome   unpublished
ordinal scale. Overall subjective satisfaction, radiological improvements, AOFAS forefoot score, and subjective Foot function index were also assessed. Correlation between overall satisfaction after surgery and above other factors was performed. Statistical analysis was done using SPSS and Spearman's rho rank correlation test was performed to analyse the correlation between factors. Results: Mean follow-up was 38 months (range; 24~54). For preoperative expectations, 30 (75%) patients considered
more » ... improvement in pain as the most important parameter and improvements in shoe wearable and gross appearance were expected in 7 (17.5%) and 3 (7.5%) patients, respectively. Fulfilment of expectations assessed showed very satisfied in 14 (35%), satisfied in 20 (50%), average in 5 (12.5%) and disappointed in 1 (2.5%) for great toe, and those regarding lesser toe showed very satisfied in 15 (37.5%), satisfied in 18 (45%), average in 6 (15%) and disappointed in 1 (2.5%), respectively. For overall postoperative satisfaction assessment, 16 patients (40%) were excellent while 16 (40%) were good, 6 (15%) fair, and 2 (5%) poor. AOFAS hallux and lesser toe score were 69.7 ±11.71 and 70.7±12.26, respectively. Foot function index was 20.5±12.07 at final follow-up. Preoperative and postoperative hallux valgus angle were 45.6°± 10.55 and 17.4°±5.13, respectively. Those of 1-2 intermetatarsal angle were 14.2°±3.84 and 8.4°±3.72, respectively. Correlation analysis showed that significant factors that affected on overall satisfaction were fulfilment of expectation on the great toe (Spearman's rho=0.842, p<0.001)and that of lesser toe, and AOFAS score. Radiological degree and improvement in HVA and IMA were not significantly associated with patient's satisfaction. Conclusions: Expectations from surgery on rheumatoid forefoot deformity were improvement in pain as the most common parameter, improvements in shoe wearable and gross appearance. Fulfilment of patients' expectations on the great toe as well as on the lesser toe significantly affected on postoperative satisfaction. Careful counselling for patients' expectations and corresponding fulfilment should be performed before performing reconstructive surgery for rheumatoid forefoot deformity.
doi:10.1136/annrheumdis-2018-eular.2515 fatcat:nr2qp47o2ncmxpf46xmueuwnsu