Comparative study of metacarpophalangeal joint arthroplasty effectiveness in patients with rheumatoid hand

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Abstract

Objective - to determine the optimal implant for metacarpophalangeal joint arthroplasty in patients with rheumatoid hand. Materials and methods. 24 patients with rheumatoid hand were operated in Vreden Russian Research Institute of Traumatology and Orthopedics (St.-Petersburg, Russia). 37 MCPJ arthroplasties were performed with 129 implants of 3 types. First group consisted of 11 patients with 43 implanted NeuFlex “DePuy International Ltd.” silicone implants on 12 hands. Second group - 6 patients with 26 implants Daphne “TECRES S.p.A.” on 7 hands. Third group - 16 patients with 60 implants RM Finger “MATHYS AG Bettlach” on 17 hands. Criteria for treatment effectiveness were estimated taking into account hand function, complications and also relapse of deformation. We compared movement amplitude in MCP joins, angle of ulnar drift, strength of hand and also subjective assessment by patients with DASH. Results were fixed before surgery and 3, 6 and 12 months after. Results. Complications were recorded in I and II of patient groupsin 50% of cases:fracturesof components, dislocations of construction, relapse of ulnar drift. Complications in III group of patients were not detected. Range of motion and function improvement were increased in all groups (p>0,05), as well as strength of hand. But the most stable growth of hand strength was fixed only in III group (p<0,05). Relapse of ulnar drift occurred in I group of patients. Conclusion. RM Finger “MATHYS AG Bettlach” is more reliable for metacarpophalangeal joint arthroplasty since it provides stable long-term results of treatment.

About the authors

L. A. Rodomanova

Vreden Russian Research Institut of Traumatology and Ortopedics; Nort-Western State Medical University

Author for correspondence.
Email: afar_kav@mail.ru
Россия

A. O. Afanas’Yev

Vreden Russian Research Institute of Traumatology and Orthopedics

Email: noemail@neicon.ru
Россия

References

  1. Белоусов А.Е. Пластическая реконструктивная и эстетическая хирургия. СПб.: Гиппократ; 1998. 751 с.
  2. Каратеев Д.Е. Ревматоидная кисть. Consilium Medicum. 2005; 7(2):83-87.
  3. Коломацкий В.В., Асин Б.А., Макаров С.А., Архипов С.В., Павлов В.П. эндопротезирование пястно-фаланговых суставов у пациентов с ревматоидным артритом. Научно-практическая ревматология. 2006; (4):97-100.
  4. Насонов Е.Л. Ревматоидный артрит как общемедицинская проблема. Терапевтический архив. 2004; (5):5-7.
  5. Abboud J.A., Beredjiklian P.K., Bozentka D.J. Metacarpophalangeal joint arthroplasty in rheumatoid arthritis. J Am Acad Orthop Surg. 2003; 11(3):184-191.
  6. Bielefeld T., Neumann D.A. The unstable metacarpophalangeal joint in rheumatoid arthritis: anatomy, pathomechanics, and physical rehabilitation considerations. J Orthop Sports Phys Ther. 2005; 35(8):502-520.
  7. Chung K.C., Nellans K.W., Burns P.B., Wilgis E.F., Burke F.D., Fox D.A., Kim H.M. Patient expectations and longterm outcomes in rheumatoid arthritis patients: results from the SARA (siliconearthroplasty in rheumatoid arthritis) study. Clin Rheumatol. 2014 [Epub ahead of print].
  8. Chung K.C., Kotsis S.V., Kim H.M. A prospective outcomes study of Swanson metacarpophalangeal joint arthroplasty for the rheumatoid hand. J Hand Surg Am. 2004; 29(4):646-653.
  9. Chung К.С., Kotsis S.V., Kim H.M., Burke F.D., Wilgis E.F. Reasons why rheumatoid arthritis patients seek surgical treatment for hand deformities. J Hand Surg Am. 2006; 31(2): 289-294.
  10. Chung K.C., Kotsis S.V. Outcomes of hand surgery in the patient with rheumatoid arthritis. Curr Opin rheumatol. 2010; 22(3): 336-341.
  11. Darke M.L., Segalman K.A. Complications of small joint artroplasty. Hand Clin. 2010; 26(2):205-212.
  12. Derkash R.S., Niebauer I.J., Lane C.S. Long-term follow-up of metacarpophalangeal arthroplasty with silicone Dacron prostheses. J Hand Surg Am. 1986; 11:553.
  13. Dobyns J.H., Linscheid R.L. Rheumatoid hand repairs. Orthop Clin North Am. 1971; 2:629.
  14. Goldfarb C.A., Stern P.J. Metacarpophalangeal joint arthroplasty in rheumatoid arthritis. A long-term assessment. J Bone Joint Surg Am. 2003; 85(10): 1869-1878.
  15. Gupta K., Haussmann P. Synovialectomy of the Metacarpophalangeal joint with reconstruction of the radial collateral ligament-long-term results in patients suffering from rheumatoid arthritis. Handchir Mikrochir Plast Chir. 2005; 37(10):35-39.
  16. Joyse T.J., Unsworth A. A literature review of «failures» of the Swanson finger prosthesis in the metacarpophalangeal joint. J Hand Surgery. 2002; 7(1):139-146.
  17. Kirschenbaum D., Schneider L.H., Adams D.C., Cody R.P. Arthroplasty of the metacarpophalangeal joints with use of Silastic rubber implants in patients who have rheumatoid arthritis: Long-term results. J Bone Joint Surg. 1993; 75:3.
  18. Kleinert J.M., Lister G.D. Silicone implants. Hand Clin. 1986; 2(2):271-290.
  19. Moller K., Sollerman C., Geijer M., Kopylov P., Tagil M. Avanta versus Swanson silicone implants in the MCP joint-a prospective, randomized comparison of 30 patient followed for 2 yers. J Hand Surg Br. 2005; 30(1):8-13.
  20. Morrey B.F. Joint replacement arthroplasty. Elsevier; 2003. 1171 p.
  21. Norris S.H. Surgery for the rheumatoid wrist and hand. Ann of the Rheumatic Diseases. 1990; 49:863-870.
  22. Petrolati M., Abbiati G., Delaria G., Soffiatti R., Robotti P., Guerriero C. A new prosthesis for the metacarpophalangeal joints. Study of materials and biomechanics. J Hand Surg Br-. 1999; 24(1):59-63.
  23. Simpson-White R.W., Chojnowski A.J. Pyrocarbon metacarpophalangeal joint replacement in primary osteoarthritis. J Hand Surg Eur Vol. 2013; 39(6):575-581.
  24. Wall L.B., Stern P.J.J. Clinical and radiographic outcomes of metacarpophalangeal joint pyrolytic carbon arthroplasty for osteoarthritis. Hand Surg Am. 2013; 38(3):537-543.

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