Isoelastic arthroplasty of the metacarpophalangeal joints in rheumatoid arthritis: A preliminary report

Vermeiren, J. A. M.; Dapper, M. M. L.; Schoonhoven, Léon; Merx, Peter

doi:10.1016/0363-5023(94)90027-2

Cited by 13 publications

(5 citation statements)

References 15 publications

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“…4,5 Use of the silicone implant remains the criterion standard, but implant fracture and recurrent instability are common over mediumto long-term follow-up. [1][2][3][4]6,7,17 The SRA was designed and introduced as an alternative to silicone. The aim of this study was to examine our institution's experience with the SRA MCP arthroplasty.…”

Section: Discussionmentioning

confidence: 99%

“…Silicone metacarpophalangeal (MCP) joint arthroplasty has been used to treat symptomatic rheumatoid arthritis (RA) since the 1960s. [1][2][3][4][5][6][7] Silicone implants have been shown to improve function and pain at the MCP joint in some patients with RA. [8][9][10][11] Despite this, high rates of mechanical failure have been reported in silicone implants after long-term follow-up in patients with RA.…”

Section: Introductionmentioning

confidence: 99%

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Long-term Outcomes of MCP Surface Replacement Arthroplasty in Patients With Rheumatoid Arthritis

Claxton

Wagner

Rizzo

2020

Hand (New York, N,Y.)

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Background: Surface replacement arthroplasty (SRA) can be used in the treatment of rheumatoid arthritis (RA) affecting the metacarpophalangeal (MCP) joint. The authors of this study sought to investigate the outcomes of MCP SRA in patients with RA. Methods: Retrospective review of medical records and an institutional joint registry were used to gather data on 80 MCP SRAs performed in 27 patients with RA. Data collected included demographics, SRA revisions, reoperations, complications, pain, and MCP arc of motion. Results: The mean postoperative follow-up was 9.5 years (range, 2.1-20.5 years), with all SRAs achieving at least 2 years of follow-up. Thirteen digits (16%) underwent revision arthroplasty, and 29 (36%) required reoperation. The 5-, 10-, 15-, and 20-year rates of survival from implant revision were 95%, 85%, 80%, and 69%, respectively. The 5-, 10-, 15-, and 20-year rates of survival from overall reoperation were 80%, 65%, 55%, and 46%, respectively. Metacarpophalangeal joint arc of motion, grip strength, and pain levels significantly improved following surgery. Conclusions: Metacarpophalangeal SRA can offer benefit to patients with RA for improvement in function and pain. High overall reoperation rates remain concerning; however, most do not involve arthroplasty revision.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Long-term Outcomes of MCP Surface Replacement Arthroplasty in Patients With Rheumatoid Arthritis

Claxton

Wagner

Rizzo

2020

Hand (New York, N,Y.)

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“…Swanson introduced silicone implants for metacarpophalangeal (MCP) joint arthroplasty in rheumatoid arthritis (Swanson, 1972). Several other implant designs have since been marketed (Adams et al, 1990; Beevers and Seedholm, 1995; Cook et al, 1999; Flatt, 1967; Linscheid, 2000; Lundborg et al, 1993; Möller et al, 1999; Vermeiren et al, 1994). The Swanson implant changed from silicone to high performance (HP) silicone in 1975 and to HP 100-silicone in 1986 to provide better durability.…”

Section: Introductionmentioning

confidence: 99%

Avanta Versus Swanson Silicone Implants in the MCP Joint—A Prospective, Randomized Comparison of 30 Patients Followed for 2 Years

Möller

Sollerman

Geijer

et al. 2005

Journal of Hand Surgery

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The results of Swanson and Avanta metacarpophalangeal joint arthroplasties in rheumatoid patients were compared in a prospective, randomized study of 30 patients (120 implants). At 2-year follow-up, grip strength was measured, hand function was assessed with the Sollerman test and the subjective outcome was determined with visual analogue scores. With both implants ulnar deviation and flexion deformities decreased, and there was no difference between the groups. The increase in range of motion was 7° greater with Avanta implants than with Swanson implants. Grip strength and hand function were unaltered but the visual analogue scales showed decreased pain levels and subjective improvements in hand function, grip strength and cosmesis. Twenty-four of 30 patients were satisfied. Fracture of the silicone spacer occurred with 12 Avanta (20%) and eight Swanson implants (13%), with a higher fracture frequency in men.

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“…The two components are snapped together afterwards (hinge joint). The main problem was the migration of the prosthesis so, within a few months postoperatively, the Range Of Motion (ROM) was very poor [21][22][23], which led to its withdrawn from the marketplace. The second design of the constrained Mathys prosthesis (RM prosthesis) with its hinge joint which was used in our case consists of two polyetheretherketone (PEEK) components ( Figure 2B).…”

Section: Discussionmentioning

confidence: 99%

A 10-Year Follow-Up of Uncemented Constrained Metacarpophalangeal Joint Arthroplasties Using the RM Prosthesis in a Patient with Rheumatoid Arthritis.

Schmidt¹

2017

JRAD

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A 72-year-old male with high-demand activities of daily living presented with rheumatoid arthritis mostly affected finger joints of his right hand. Radiographically, there was severe destruction with luxation of metacarpophalangeal joints (MCPJs) II-V. The constrained RM prostheses were inserted into the MCPJs II-V typically in the uncemented manner, and the course was primarily complicated due to periprosthetic fracture of the metacarpal IV intraoperatively, that was treated with immobilization in a plaster splint for 6 weeks. After that, the course was uncomplicated. Eight years after primary surgery, the patient reported increasing pain with loss of function isolated in his MCPJ IV since 6 months; all other finger joints did not reveal any clinically relevant symptoms. Radiographically, distinctive osteolyses with cortical thinning around all components of the 4 RM prostheses were seen, and the hinge joint of implant in MCPJ IV was broken. A total exchange arthroplasty of the MCPJ IV using the unconstrained MCPJ resurfacing SR TM MCP implant with cementation of both components was performed. At the 10-year follow-up, that includes a 2-year followup after MCPJ IV exchange arthroplasty, there was unchanged correct positioning of all MCPJ implants; and despite distinctive radiographic loosening and subsidence of the 3 other RM prostheses, the patient is able to perform his high-demand activities of daily living.

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Isoelastic arthroplasty of the metacarpophalangeal joints in rheumatoid arthritis: A preliminary report

Cited by 13 publications

References 15 publications

Long-term Outcomes of MCP Surface Replacement Arthroplasty in Patients With Rheumatoid Arthritis

Long-term Outcomes of MCP Surface Replacement Arthroplasty in Patients With Rheumatoid Arthritis

Avanta Versus Swanson Silicone Implants in the MCP Joint—A Prospective, Randomized Comparison of 30 Patients Followed for 2 Years

A 10-Year Follow-Up of Uncemented Constrained Metacarpophalangeal Joint Arthroplasties Using the RM Prosthesis in a Patient with Rheumatoid Arthritis.

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