Hindfoot Surgery on the Rheumatic and Osteoarthritic Foot

Although the hindfoot is often affected in osteoarthritic patients and in over 90% of rheumatic patients, it is less often the focus of attention than other joints. Changes should be recorded and treated early and regularly to preserve mobility. In the past few years, progress has been made in the diagnostic investigation and treatment of rheumatics, but the "common foot surgery" does not fit these principles yet. The involvement of all structures in the disease process leads to limited treatment options in the hindfoot and midfoot. Initially, orthopedic (shoe) alterations are the treatment of choice. Joint-preserving surgery is usually only possible in osteoarthritis patients. In rheumatics, the joint surfaces are already damaged at an early stage, which means that only arthrodesis is promising. At the same time, surgical treatment has to be performed earlier and more "aggressively" than in patients suffering from osteoarthritis. When planning and deciding on surgical treatment, concomitant osteoporosis should always be taken into account.