Metacarpophalangeal Joint Prostheses

Beevers, D J; Seedhom, B B

doi:10.1016/s0266-7681(05)80038-5

Cited by 82 publications

(11 citation statements)

References 73 publications

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“…The function of a finger joint after implantation of a prosthesis may therefore be dependent more on the reaction of the surrounding tissue and less on the design of the prosthesis. Different types of prosthesis for the metacarpophalangeal joint showed comparable fair clinical results at the short and middle-term follow-up (2,15). The silicone spacers offer good options in salvage procedures when compared with other systems.…”

Section: Discussionmentioning

confidence: 94%

Ten-Year Follow-Up of Silicone Arthroplasty of the Metacarpophalangeal Joints in Rheumatoid Hands

Schmidt

1999

Scandinavian Journal of Plastic and Reconstructive Surgery and

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In resection arthroplasty of destroyed metacarpophalangeal joints stabilisation with a silicone spacer is regarded as the gold standard. In 28 patients with rheumatoid arthritis (34 hands) 102 arthroplasties of the metacarpophalangeal joint were assessed a median of 10 years postoperatively (range 8.7-12.5). All patients reported pronounced subjective relief of pain, and in three quarters function of the hand had improved. The median active range of movement decreased from 40 degrees (range 10 degrees-90 degrees) preoperatively to 35 degrees (range 5 degrees-85 degrees) postoperatively. Ulnar deviation was corrected from a median of 35 degrees (range 0 degrees-60 degrees) preoperatively to 10 degrees (range 0 degrees-40 degrees) postoperatively. The extension deficit was improved from a median of 35 degrees (range 10 degrees-80 degrees) before surgery to a median of 10 degrees (range 0 degrees-30 degrees) at follow up. Grip strength remained unchanged. Radiological examination showed surrounding osteolysis in 89% of the implants and 28% had broken. The well-known discrepancy between fair clinical and good subjective results with distinct radiological findings such as osteolysis was therefore confirmed. Material fatigue and sharp bony edges that result from osteolysis may be the cause of the relatively common implant fractures and ulnar deviation in this long-term follow-up.

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Section: Discussionmentioning

confidence: 94%

Ten-Year Follow-Up of Silicone Arthroplasty of the Metacarpophalangeal Joints in Rheumatoid Hands

Schmidt

1999

Scandinavian Journal of Plastic and Reconstructive Surgery and

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“…The first reported surgical procedure using an endoprosthesis for replacement of the MCP-joints was performed in the beginning of the 1950s and since then a variety of endoprostheses have been presented [3]. The joint mechanism might be constrained using a polymer, such as silicone, as the flexible hinge, or non-constrained using a ball-in-socket concept.…”

Section: Arthroplasty Of the Mcp-jointsmentioning

confidence: 99%

How I do it—MP joint arthroplasty

Sollerman

2006

International Congress Series

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“…Since then, several different endoprosthetic models have been presented [10]. Joint mechanics is generally based on one of two main principles: 1) a twopiece, hinged joint mechanism which allows flexion and extension; 2) a solid flexible component of silicone or other polymer which can be deformed to permit mobility in flexion and extension, but also deviation (adduction/abduction).…”

Section: Endoprosthesismentioning

confidence: 99%

The hand

2000

Acta Orthopaedica Scandinavica

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Submit your article to this journalArticle views: 57 The hand Typical deformities in rheumatoid arthritis include ulnar drift of the fingers, swan-neck and Boutonnière deformity (imbalance and malalignment of the PIP and DIP joints of the fingers), and shoemaker's thumb. These malalignments, along with pain and decreased mobility, may seriously impair hand function.The goal of surgical treatment is to: -achieve pain relief -counteract deterioration -improve function -achieve cosmetic improvement.Soft tissue surgery, eg, synovectomy in joints and tendon sheaths, for joint pain or mobility problems, tendon transfer for deviated fingers or following tendon rupture, and neurolysis to treat compression of peripheral nerves, can often improve hand function and counteract deterioration.If the joints are more or less destroyed by the rheumatic process, arthrodesis may be a suitable treatment in some joints (the MCP joint of the thumb, DIP joints of the fingers), while arthroplasty is the most appropriate surgical approach in other joints (the MCP joints of the fingers).The data in this chapter are based mainly on retrospective clinical and radiological studies of rheumatic patients. AnatomyThe bones and joints of the hand (starting from the wrist) consist of 5 carpometacarpal joints (CMC I-V) between the wrist (carpal bones) and metacarpal bones, 5 metacarpophalangeal joints (MCP I-V) between the metacarpal bones and phalangeal bones, and proximal and distal interphalangeal joints (PIP and DIP joints) between the different phalangeal bones. Mobility in CMC I (saddle joint) is good which, eg, enables the thumb to be positioned in opposition to the fingers. Other CMC joints have little or no mobility; CMC II and III are tight joints. The MCP joints have a mobility of approximately 90° from extended to flexed position, and also have the capacity to deviate to the side so the hand grip can adapt to the shape of an object. The PIP and DIP joints are hinge joints with mobility of approximately 100° (PIP) and 70° (DIP) respectively.

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Metacarpophalangeal Joint Prostheses

Cited by 82 publications

References 73 publications

Ten-Year Follow-Up of Silicone Arthroplasty of the Metacarpophalangeal Joints in Rheumatoid Hands

Ten-Year Follow-Up of Silicone Arthroplasty of the Metacarpophalangeal Joints in Rheumatoid Hands

How I do it—MP joint arthroplasty

The hand

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