Metacarpophalangeal Joint Arthroplasty in Rheumatoid Arthritis : A Long-Term Assessment

BackgroundThe long-term results of silicone metacarpophalangeal arthroplasty in patients with rheumatoid arthritis are uncertain. The purpose of this investigation was to evaluate the subjective, objective, and radiographic outcomes at the time of long-term follow-up.MethodsPatients with rheumatoid...

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Bibliographic Details
Published in:Journal of bone and joint surgery. American volume 2003-10, Vol.85 (10), p.1869-1878
Main Authors: Goldfarb, Charles A, Stern, Peter J
Format: Article
Language:English
Subjects:
Adult
Aged
Arthritis, Rheumatoid - diagnostic imaging
Arthritis, Rheumatoid - physiopathology
Arthritis, Rheumatoid - surgery
Arthroplasty, Replacement
Biological and medical sciences
Female
Follow-Up Studies
Humans
Joint Prosthesis
Male
Medical sciences
Metacarpophalangeal Joint - diagnostic imaging
Metacarpophalangeal Joint - physiopathology
Metacarpophalangeal Joint - surgery
Middle Aged
Orthopedic surgery
Radiography
Range of Motion, Articular - physiology
Silicones
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Time Factors
Treatment Outcome
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Summary:BackgroundThe long-term results of silicone metacarpophalangeal arthroplasty in patients with rheumatoid arthritis are uncertain. The purpose of this investigation was to evaluate the subjective, objective, and radiographic outcomes at the time of long-term follow-up.MethodsPatients with rheumatoid arthritis who underwent simultaneous silicone metacarpophalangeal joint arthroplasties of all four fingers by one surgeon were eligible for inclusion in the study. The results of a total of 208 arthroplasties in fifty-two hands of thirty-six patients were evaluated at an average of fourteen years postoperatively. Active metacarpophalangeal joint motion, ulnar drift, and radiographs were assessed. The radiographs were reviewed for changes in bone length, erosions, and implant fractures. The Michigan Hand Outcomes Questionnaire (MHQ) was administered to the patients.ResultsThe mean arc of motion of the metacarpophalangeal joints improved from 30° preoperatively to 46° immediately after the surgery but decreased to 36° at the time of final follow-up. The mean extension deficit of the metacarpophalangeal joints improved from 57° preoperatively to 11° immediately after the surgery but worsened to 23° at the time of final follow-up. The mean ulnar drift improved from 26° preoperatively to
ISSN:0021-9355
1535-1386
DOI:10.2106/00004623-200310000-00001