The Journal of Bone and Joint Surgery, Vol 75, Issue 1 3-12, Copyright © 1993 by Journal of Bone and Joint Surgery, Inc
Arthroplasty of the metacarpophalangeal joints with use of silicone-rubber implants in patients who have rheumatoid arthritis. Long-term results
D Kirschenbaum, LH Schneider, DC Adams and RP Cody
Department of Orthopaedic Surgery, Thomas Jefferson Medical College of Thomas Jefferson University, Philadelphia.
The long-term results of 144 arthroplasties of the metacarpophalangeal
joints, with use of silicone-rubber implants, were reviewed for
twenty-seven patients (thirty-six hands) who had rheumatoid arthritis. The
operations were all performed or supervised by the same surgeon. All
patients had an arthroplasty of the metacarpophalangeal joint of all four
fingers, and all had subjective and objective clinical evaluation and
roentgenographic assessment. Relief of pain, the cosmetic appearance of the
hand, the range of motion of the metacarpophalangeal and proximal
interphalangeal joints, and the presence of residual deformity were
evaluated. The average duration of follow-up was eight years and six months
(range, five years to sixteen years and three months). Preoperatively, the
mean active-extension deficit of the metacarpophalangeal joints ranged from
53 degrees (index finger, right hand) to 70 degrees (little finger, left
hand) and the mean flexion ranged from 84 degrees (index finger, right
hand) to 94 degrees (little finger, left hand). At the early follow-up
evaluation (average, four months postoperatively; range, two to six
months), the mean extension deficit had improved to a range of 7 degrees
(little finger, right hand) to 19 degrees (index finger, left hand), and
mean flexion ranged from 56 degrees (little finger, left hand) to 66
degrees (ring fingers). The range of motion had improved from a
non-functional arc of flexion to a more functional arc of extension. At the
time of the latest follow-up visit, the motion of the metacarpophalangeal
joints had not deteriorated.(ABSTRACT TRUNCATED AT 250 WORDS)
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